Faculty of Medicine, Université de Sherbrooke, Longueuil, Canada; Charles LeMoyne Hospital Research Center, Canada.
J Affect Disord. 2013 Dec;151(3):1083-9. doi: 10.1016/j.jad.2013.08.038. Epub 2013 Sep 9.
Bereavement is a phenomenon that shares many symptoms with depression, and that a great number of older adults experience following the loss of a close relative. The objectives of the present study were to (1) determine whether the symptoms of depression reported by bereaved individuals differ from those with non-bereavement minor/major depression (NBRD), (2) assess whether BRD is as persistent during a one year follow-up as compared to NBRD, and (3) identify factors and consequences associated with BRD.
The data used for this study came from the Longitudinal Study ESA (Study Health of Elders), conducted between 2005 and 2008, using a representative sample (n=2811) of community-dwelling older adults, aged 65 and over. To test our hypothesis, an exploratory latent class analysis and multivariate logistic regression were used.
BRD prevalence among older adults suffering from depression was 39%. BRD individuals report all symptoms of depression, but in lower probabilities, and BRD is as persistent as MDD over 12 months, suggesting that it does not differ from NBRD. The principal factors associated with BRD were widowhood and lower level of education. Individuals with BRD are less likely to consult medical services and be dispensed an antidepressant, compared to NBRD.
We have to be cautious when generalizing our findings to individuals with major depression alone, since our results included both minor and major depressions in the same group.
No evidence was found that BRD differed from non BRD in terms of depressive symptoms and persistence. The bereavement exclusion criterion in the DSM-IV should be reconsidered.
丧亲是一种与抑郁有许多共同症状的现象，许多老年人在失去亲密的亲人后都会经历这种情况。本研究的目的是：(1)确定丧亲个体报告的抑郁症状是否与非丧亲轻/重抑郁障碍(NBRD)不同；(2)评估 BRD 在一年随访期间是否与 NBRD 一样持续存在；(3)确定与 BRD 相关的因素和后果。
本研究使用了 2005 年至 2008 年期间进行的“老年人健康纵向研究”(ESA 研究)的数据，该研究使用了一个代表性样本(n=2811)，包括年龄在 65 岁及以上的社区居住老年人。为了检验我们的假设，我们使用了探索性潜在类别分析和多变量逻辑回归。
在患有抑郁症的老年人中，BRD 的患病率为 39%。BRD 个体报告了所有的抑郁症状，但可能性较低，并且在 12 个月内与 MDD 一样持续存在，这表明它与 NBRD 没有区别。与 BRD 相关的主要因素是丧偶和较低的教育水平。与 NBRD 相比，BRD 个体更不可能咨询医疗服务和开抗抑郁药。
我们在将研究结果推广到仅有重度抑郁症的个体时需要谨慎，因为我们的结果将轻度和重度抑郁症都包括在同一组中。
没有证据表明 BRD 在抑郁症状和持续时间方面与非 BRD 不同。DSM-IV 中的丧亲排除标准应重新考虑。
