Li Y, Aggen S, Shi S, Gao J, Li Y, Tao M, Zhang K, Wang X, Gao C, Yang L, Liu Y, Li K, Shi J, Wang G, Liu L, Zhang J, Du B, Jiang G, Shen J, Zhang Z, Liang W, Sun J, Hu J, Liu T, Wang X, Miao G, Meng H, Li Y, Hu C, Li Y, Huang G, Li G, Ha B, Deng H, Mei Q, Zhong H, Gao S, Sang H, Zhang Y, Fang X, Yu F, Yang D, Liu T, Chen Y, Hong X, Wu W, Chen G, Cai M, Song Y, Pan J, Dong J, Pan R, Zhang W, Shen Z, Liu Z, Gu D, Wang X, Liu X, Zhang Q, Flint J, Kendler K S
Wellcome Trust Centre for Human Genetics, Oxford, UK.
Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA.
Psychol Med. 2014 May;44(7):1391-401. doi: 10.1017/S003329171300192X. Epub 2013 Aug 7.
The symptoms of major depression (MD) are clinically diverse. Do they form coherent factors that might clarify the underlying nature of this important psychiatric syndrome?
Symptoms at lifetime worst depressive episode were assessed at structured psychiatric interview in 6008 women of Han Chinese descent, age ⩾30 years with recurrent DSM-IV MD. Exploratory factor analysis (EFA) and confirmatoryfactor analysis (CFA) were performed in Mplus in random split-half samples.
The preliminary EFA results were consistently supported by the findings from CFA. Analyses of the nine DSM-IV MD symptomatic A criteria revealed two factors loading on: (i) general depressive symptoms; and (ii) guilt/suicidal ideation. Examining 14 disaggregated DSM-IV criteria revealed three factors reflecting: (i) weight/appetite disturbance; (ii) general depressive symptoms; and (iii) sleep disturbance. Using all symptoms (n = 27), we identified five factors that reflected: (i) weight/appetite symptoms; (ii) general retarded depressive symptoms; (iii) atypical vegetative symptoms; (iv) suicidality/hopelessness; and (v) symptoms of agitation and anxiety.
MD is a clinically complex syndrome with several underlying correlated symptom dimensions. In addition to a general depressive symptom factor, a complete picture must include factors reflecting typical/atypical vegetative symptoms, cognitive symptoms (hopelessness/suicidal ideation), and an agitated symptom factor characterized by anxiety, guilt, helplessness and irritability. Prior cross-cultural studies, factor analyses of MD in Western populations and empirical findings in this sample showing risk factor profiles similar to those seen in Western populations suggest that our results are likely to be broadly representative of the human depressive syndrome.
重度抑郁症（MD）的症状在临床上多种多样。它们是否构成连贯的因素，从而可能阐明这一重要精神综合征的潜在本质？
在对6008名年龄≥30岁、患有复发性DSM-IV重度抑郁症的汉族女性进行结构化精神科访谈时，评估其一生中最严重抑郁发作时的症状。在Mplus中对随机分成的两半样本进行探索性因素分析（EFA）和验证性因素分析（CFA）。
CFA的结果一致支持了初步EFA的结果。对DSM-IV重度抑郁症的九条症状A标准进行分析，发现有两个因素负荷于：（i）一般抑郁症状；以及（ii）内疚/自杀观念。对14条细分的DSM-IV标准进行检查，发现有三个因素反映：（i）体重/食欲紊乱；（ii）一般抑郁症状；以及（iii）睡眠障碍。使用所有症状（n = 27），我们确定了五个因素，分别反映：（i）体重/食欲症状；（ii）一般迟缓性抑郁症状；（iii）非典型植物神经症状；（iv）自杀倾向/绝望感；以及（v）激越和焦虑症状。
重度抑郁症是一种临床复杂的综合征，具有几个潜在的相关症状维度。除了一般抑郁症状因素外，完整的情况还必须包括反映典型/非典型植物神经症状、认知症状（绝望感/自杀观念）以及以焦虑、内疚、无助和易怒为特征的激越症状因素。先前的跨文化研究、西方人群中重度抑郁症的因素分析以及本样本中显示与西方人群相似的危险因素概况的实证研究结果表明，我们的结果可能广泛代表人类抑郁综合征。
