Division of Geriatric Medicine, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Department of Geriatrics, County Council of Östergötland, Sweden.
Department of Social and Welfare Studies, Faculty of Health Sciences, Linköping University, LAH/Unit of Palliative Care, County Council of Östergötland, and Palliative Education and Research Centre in the County of Östergötland, Sweden.
Gerontologist. 2015 Oct;55(5):760-9. doi: 10.1093/geront/gnt162. Epub 2014 Jan 7.
The aim of this study was to make a qualitative comparison of experiences of being in very old people with subsyndromal depression (SSD), in relation to the experiences of very old people with syndromal depression or nondepression. Through investigation and deeper understanding of the interface between depressive disease and normal aging, clinicians might give more accurate prevention or treatment to those very old persons who need such help.
Semistructured qualitative interviews were conducted for 27 individuals of 87-88 years of age, who were categorized in the 3 strata of nondepressive, SSD, and syndromal depression. Transcripts were analyzed using qualitative content analysis within each stratum and later with a comparison between the strata.
The content analysis resulted in 4 themes in people with SSD, as defined by a self-report depression screening instrument, giving a comprehensive picture of SSD in very old people, and also showed qualitative differences between the SSD, syndromal depression, and nondepressive groups. A main finding was that SSD differs qualitatively from syndromal depression but not clearly from nondepression.
The results might indicate that SSD in very old people is not related to pathology but to normal aging, even though the condition correlates with negative health parameters. Overlooking certain psychosocial aspects of living in the very old may pose a risk of both underdiagnosis and overdiagnosis in the spectrum of depressive disorders.
本研究旨在对亚综合征抑郁（SSD）的高龄患者体验进行定性比较，与综合征抑郁或非抑郁的高龄患者体验进行比较。通过对抑郁疾病与正常衰老之间的界面进行调查和深入了解，临床医生可能会为那些需要此类帮助的高龄患者提供更准确的预防或治疗。
对 27 名年龄在 87-88 岁的个体进行了半结构式定性访谈，这些个体被分为无抑郁、SSD 和综合征抑郁 3 个层次。在每个层次内使用定性内容分析对转录本进行分析，然后在层次之间进行比较。
内容分析产生了 4 个主题，这些主题是通过自我报告的抑郁筛查工具定义的 SSD，全面描述了高龄患者的 SSD，同时也显示了 SSD、综合征抑郁和无抑郁组之间的定性差异。一个主要发现是，SSD 在定性上与综合征抑郁不同，但与非抑郁没有明显区别。
结果可能表明，高龄患者的 SSD 与病理学无关，而是与正常衰老有关，尽管这种情况与负面健康参数相关。在高龄人群中，忽视某些心理社会方面的生活可能会对抑郁障碍谱中的诊断不足和过度诊断构成风险。
