Mood and Anxiety Disorders Program, Emory University Department of Psychiatry and Behavioral Sciences, 1256 Briarcliff Rd, 3rd Floor North, Atlanta, GA 30306
J Clin Psychiatry. 2013 Nov;74(11):1084-91. doi: 10.4088/JCP.12m08194.
To explore which symptoms are common in patients who experience a range of symptom severity that spans minor depression and major depressive disorder (MDD).
A post hoc analysis of subjects entering outpatient, pharmacologic treatment studies for minor depression or MDD who provided baseline data on the Inventory for Depressive Symptomatology-Clinician Rated (IDS-C) was performed in November 2000. The minor depression sample included 161 patients diagnosed according to the National Institute of Mental Health Diagnostic Interview Schedule, while the MDD subjects included 969 subjects diagnosed according to the Structured Clinical Interview for DSM-III-R. Descriptive statistics were calculated for the total IDS-C score and for each item-rating score for both groups. The percentages of patients within the low, medium, and high severity groups of minor depression and MDD endorsing each IDS-C item were calculated and used to identify specific patterns of prevalence across the 6 groups: symptoms with high prevalence in all groups (core symptoms), those with increasing prevalence across groups (continuum symptoms), and those that become prominent only at a certain threshold of illness severity.
The mean (SD) IDS-C score was 21.18 (5.37) for minor depression patients, while it was 37.14 (7.27) for the MDD patients (P = .0001). Ten items pertaining mostly to mood state and cognition were identified as "core" symptoms of depression based on their high prevalence in all groups. Fourteen items consisting mostly of neurovegetative and somatic symptoms were identified as "continuum" symptoms based on their general pattern of increasing prevalence across the 6 severity groups. Four "threshold" symptoms, including suicidal ideation, psychomotor slowing, gastrointestinal symptoms, and panic/phobic symptoms, were prevalent in only the most severely depressed groups.
The presence of core, continuum, and threshold depressive symptoms indicates central features of both minor depression and MDD as well as symptoms that increase or emerge with depressive illness severity. Some of the core symptoms of minor depression and MDD are not included in DSM depressive criteria or traditional assessment rating scales.
探讨在经历轻度抑郁和重度抑郁障碍（MDD）等不同严重程度的患者中，哪些症状较为常见。
2000 年 11 月对进入门诊接受药物治疗的轻度抑郁或 MDD 患者进行了事后分析，这些患者在基线时提供了抑郁症状自评量表-临床医生评定版（IDS-C）的数据。轻度抑郁组包括 161 例根据美国国立精神卫生研究所诊断性访谈量表诊断的患者，MDD 组包括 969 例根据 DSM-III-R 定式临床访谈诊断的患者。对两组患者的 IDS-C 总分和每个项目评分进行描述性统计。计算了轻度抑郁和 MDD 的低、中、高严重程度组中每个 IDS-C 项目的患者比例，并用于确定 6 组之间的特定流行模式：所有组中具有高流行率的症状（核心症状）、随组增加的流行率症状（连续症状）以及仅在特定疾病严重程度阈值时变得突出的症状。
轻度抑郁患者的 IDS-C 平均（SD）得分为 21.18（5.37），而 MDD 患者的 IDS-C 得分为 37.14（7.27）（P=.0001）。根据其在所有组中的高流行率，10 个主要与情绪状态和认知有关的项目被确定为抑郁的“核心”症状。14 个主要由神经植物性和躯体症状组成的项目被确定为“连续”症状，因为它们在 6 个严重程度组中普遍呈现出增加的流行趋势。自杀意念、精神运动迟缓、胃肠道症状和惊恐/恐惧症症状这 4 个“阈值”症状仅在最严重的抑郁组中流行。
核心、连续和阈值抑郁症状的存在表明了轻度抑郁和 MDD 的核心特征以及随抑郁严重程度增加或出现的症状。轻度抑郁和 MDD 的一些核心症状未被纳入 DSM 抑郁标准或传统评估评分量表。
