Institut Universitari d'Investigació en Ciències de la Salut (IUNICS), Universitat de les Illes Balears (UIB), Red de Investigación en Actividades Preventivas y Promoción de la Salud (redIAPP), Palma de Mallorca, Spain.
J Affect Disord. 2013 Oct;151(1):306-12. doi: 10.1016/j.jad.2013.06.013. Epub 2013 Jul 15.
Chronic major depressive disorder (CMDD) is highly prevalent and associated with high personal and societal cost. Identifying risk factors for persistence and remission of CMDD may help in developing more effective treatment and prevention interventions.
Prospective cohort study of individuals participating in the National Epidemiologic Survey on Alcohol and Related Conditions (Wave 1; n=43,093) and its 3-year follow-up (Wave 2; n=34,653) who met a diagnosis of CMDD at the Wave 1 assessment.
Among the 504 respondents who met criteria for present CMDD at Wave 1, only 63 (11.52%) of them continued to meet criteria of CMDD. A history of childhood sexual abuse, earlier onset of MDD, presence of comorbidity and a history of treatment-seeking for depression predicted persistence of CMDD three years after the baseline evaluation.
Our sample is limited to adults, our follow-up period was only three-years and the diagnosis of CMDD at baseline was retrospective.
CMDD shows high rates of remission within three years of baseline assessment, although some specific risk factors predict a persistent course. Given the high personal and societal cost associated with CMDD, there is a need to develop and disseminate effective interventions for CMDD.
慢性重度抑郁症（CMDD）的发病率较高，给个人和社会带来了高昂的成本。识别 CMDD 持续存在和缓解的风险因素，可能有助于开发更有效的治疗和预防干预措施。
这是一项对参与国家酒精流行病学调查及相关条件调查（第 1 波；n=43093）及其 3 年随访（第 2 波；n=34653）的个体进行的前瞻性队列研究，这些个体在第 1 波评估时符合 CMDD 的诊断标准。
在第 1 波符合 CMDD 标准的 504 名受访者中，只有 63 名（11.52%）继续符合 CMDD 的标准。童年性虐待史、抑郁障碍发病较早、合并症存在和寻求抑郁症治疗的病史，可预测在基线评估 3 年后 CMDD 的持续存在。
我们的样本仅限于成年人，我们的随访期只有 3 年，并且基线时的 CMDD 诊断是回顾性的。
在基线评估后的 3 年内，CMDD 显示出较高的缓解率，尽管一些特定的风险因素预示着持续的病程。鉴于 CMDD 给个人和社会带来的高昂成本，需要开发和传播针对 CMDD 的有效干预措施。
