Department of Psychiatry, Trinity College Dublin, St. Patrick's University Hospital, Dublin 8, Ireland.
Department of Psychiatry, Trinity College Dublin, Dublin 2, Ireland.
J Affect Disord. 2013 Nov;151(2):455-460. doi: 10.1016/j.jad.2013.06.024. Epub 2013 Aug 12.
There is a dearth of studies describing clinical characteristics and outcome of patients who present with mood disorders related to economic recession.
To describe a cohort of patients admitted with first-episode depression related to the Irish economic recession and compare this cohort with all other first-episode depressives admitted during the same time period (2009-2010).
A cohort of 137 patients admitted with first-episode depression to an independent university teaching hospital was prospectively identified and followed up from admission over 2 years (mean follow-up 430 days, s.d. 176 days). The cohort was divided into "Celtic Tiger" (patients with first-episode depression secondary to the economic recession) and non-Celtic Tiger control patients (other first-episode depressed patients). Both groups were compared in terms of clinical characteristics at baseline and outcome over follow-up.
The number of admissions due to first depressive episodes were higher in recession years 2009/10 than in pre-recession years 2008/9. Celtic Tiger patients were predominantly male and more severely depressed with more marked suicidal ideation (χ(2), p<0.001) than control patients. They were more likely to recover (χ(2), p=0.013), less likely to recur (χ(2), p<0.001) and had faster time to recovery (log rank, p<0.001) and slower time to full recurrence (log rank, p=0.001). The Celtic Tiger patients spent more time asymptomatic and less time at full and subthreshold depression levels over follow-up.
Study setting of centre specializing in affective disorders treatment, retrospective nature of follow-up after initial prospective interview and lack of patient follow-up interview.
The study describes a subgroup of patients with severe depression associated with economic recession with likely high suicide risk but very favourable outcome.
目前鲜有研究描述与经济衰退相关的心境障碍患者的临床特征和结局。
描述一组因爱尔兰经济衰退而首次发作抑郁的患者，并将该组患者与同期（2009-2010 年）所有其他首发抑郁患者进行比较。
前瞻性地确定了 137 例因首次发作抑郁而入住一家独立大学教学医院的患者队列，并在 2 年的时间内从入院开始对其进行随访（平均随访 430 天，标准差 176 天）。将该队列分为“凯尔特之虎”（因经济衰退而继发首发抑郁的患者）和非凯尔特之虎对照组（其他首发抑郁患者）。比较两组患者在基线时的临床特征和随访期间的结局。
2009/10 年因首次抑郁发作而入院的人数高于经济衰退前的 2008/9 年。“凯尔特之虎”患者主要为男性，抑郁程度更严重，自杀意念更明显（卡方检验，p<0.001），与对照组患者相比。他们更有可能康复（卡方检验，p=0.013），不太可能复发（卡方检验，p<0.001），康复时间更快（对数秩检验，p<0.001），完全复发时间更慢（对数秩检验，p=0.001）。在随访期间，“凯尔特之虎”患者无症状时间更长，完全和亚阈值抑郁水平时间更短。
该研究的研究地点为专门治疗情感障碍的中心，随访是在最初的前瞻性访谈之后进行的回顾性研究，并且缺乏对患者的随访访谈。
本研究描述了一组与经济衰退相关的严重抑郁患者，这些患者自杀风险可能较高，但结局非常有利。
