Pedrelli Paola, Nyer Maren, Holt Daphne, Bakow Brianna R, Fava Maurizio, Baer Lee, Cassiello Clair, Mulligan Maura, Cusin Cristina, Farabaugh Amy
*Depression Clinical & Research Program, Massachusetts General Hospital, Boston;and †Wentworth Institute of Technology, Boston, MA.
J Nerv Ment Dis. 2013 Nov;201(11):953-8. doi: 10.1097/NMD.0000000000000038.
Depression is a prevalent psychiatric disorder associated with significant personal and societal burden. There is accumulating evidence for the presence of a subtype of depression characterized by the presence of irritability that is associated with increased morbidity, risk for suicidal ideation, and functional impairments in adults. Little is known about the features of depressive symptoms with and without irritability among young adults in college. The primary aim of this study was to characterize the presentation of college students with depressive symptoms and irritability. Two-hundred eighty-seven undergraduate college students with depressive symptoms with and without irritability were compared across several psychiatric and functional outcome variables. Independent samples t-tests or logistic regressions were conducted for each outcome variable using the irritability item of the Beck Depression Inventory as a dichotomous grouping variable. Analyses were conducted separately for the men and the women. Both male and female students with depressive symptoms and severe irritability reported a greater severity of depressive symptoms compared with their peers with no or mild irritability. In the women, the presence of irritability was associated with greater symptoms of anxiety, whereas in the men, it was associated with increased likelihood of engaging in risky behaviors, including compulsive use of alcohol, illicit drugs, and prescription drugs. The male and female college students with depressive symptoms with and without irritability did not differ on severity of suicidal ideation, hopelessness, or cognitive functioning. The findings from this study suggest that depressive symptoms and irritability may characterize a subtype of college students who have a greater symptom burden and with the potential need for more aggressive and prompt treatment.
抑郁症是一种常见的精神障碍，会给个人和社会带来重大负担。越来越多的证据表明，存在一种以易激惹为特征的抑郁症亚型，这种易激惹在成年人中与发病率增加、自杀意念风险以及功能障碍相关。对于大学生中伴有和不伴有易激惹的抑郁症状特征，人们了解甚少。本研究的主要目的是描述伴有抑郁症状和易激惹的大学生的表现。对287名伴有和不伴有易激惹的抑郁症状的本科大学生，在多个精神和功能结局变量方面进行了比较。使用贝克抑郁量表的易激惹项目作为二分分组变量，对每个结局变量进行独立样本t检验或逻辑回归分析。分别对男性和女性进行了分析。与无易激惹或轻度易激惹的同龄人相比，伴有抑郁症状和严重易激惹的男女生均报告了更严重的抑郁症状。在女性中，易激惹的存在与更严重的焦虑症状相关，而在男性中，它与从事危险行为（包括强迫使用酒精、非法药物和处方药）的可能性增加相关。伴有和不伴有易激惹的抑郁症状的男女大学生在自杀意念严重程度、绝望感或认知功能方面没有差异。本研究结果表明，抑郁症状和易激惹可能是大学生中一个亚型的特征，这些学生有更大的症状负担，可能需要更积极和及时的治疗。
