Weber Kerstin, Giannakopoulos Panteleimon, Herrmann François R, Bartolomei Javier, Digiorgio Sergio, Ortiz Chicherio Nadia, Delaloye Christophe, Ghisletta Paolo, Lecerf Thierry, De Ribaupierre Anik, Canuto Alessandra
Divisions of Liaison Psychiatry and Crisis Intervention, University Hospitals of Geneva and Faculty of Medicine of the University of Geneva, Geneva, Switzerland.
Psychogeriatrics. 2013 Dec;13(4):221-8. doi: 10.1111/psyg.12024. Epub 2013 Oct 28.
The occurrence of depression in younger adults is related to the combination of long-standing factors such as personality traits (neuroticism) and more acute factors such as the subjective impact of stressful life events. Whether an increase in physical illnesses changes these associations in old age depression remains a matter of debate.
We compared 79 outpatients with major depression and 102 never-depressed controls; subjects included both young (mean age: 35 years) and older (mean age: 70 years) adults. Assessments included the Social Readjustment Rating Scale, NEO Personality Inventory and Cumulative Illness Rating Scale. Logistic regression models analyzed the association between depression and subjective impact of stressful life events while controlling for neuroticism and physical illness.
Patients and controls experienced the same number of stressful life events in the past 12 months. However, in contrast to the controls, patients associated the events with a subjective negative emotional impact. Negative stress impact and levels of neuroticism, but not physical illness, significantly predicted depression in young age. In old age, negative stress impact was weakly associated with depression. In this age group, depressive illness was also determined by physical illness burden and neuroticism.
Our data suggest that the subjective impact of life stressors, although rated as of the same magnitude, plays a less important role in accounting for depression in older age compared to young age. They also indicate an increasing weight of physical illness burden in the prediction of depression occurrence in old age.
年轻成年人中抑郁症的发生与长期因素（如人格特质，神经质）和更急性因素（如应激性生活事件的主观影响）的综合作用有关。身体疾病的增加是否会改变老年抑郁症中的这些关联仍存在争议。
我们比较了79名重度抑郁症门诊患者和102名从未患抑郁症的对照者；受试者包括年轻人（平均年龄：35岁）和老年人（平均年龄：70岁）。评估包括社会再适应评定量表、大五人格量表和累积疾病评定量表。逻辑回归模型分析了抑郁症与应激性生活事件主观影响之间的关联，同时控制神经质和身体疾病因素。
患者和对照者在过去12个月中经历的应激性生活事件数量相同。然而，与对照者不同的是，患者将这些事件与主观负面情绪影响联系在一起。负面压力影响和神经质水平而非身体疾病，能显著预测年轻人的抑郁症。在老年人中，负面压力影响与抑郁症的关联较弱。在这个年龄组中，抑郁症还由身体疾病负担和神经质决定。
我们的数据表明，生活压力源的主观影响虽然被评定为相同程度，但与年轻人相比，在解释老年人抑郁症方面作用较小。数据还表明，身体疾病负担在预测老年抑郁症发生方面的权重在增加。
