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恢复如初:在一项对加拿大具有代表性社区样本的12年追踪研究中抑郁症的缓解情况

Bouncing back: remission from depression in a 12-year panel study of a representative Canadian community sample.

作者信息

Fuller-Thomson Esme, Battiston Marla, Gadalla Tahany M, Brennenstuhl Sarah

机构信息

Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor St. W, Toronto, ON, M5S 1V4, Canada,

出版信息

Soc Psychiatry Psychiatr Epidemiol. 2014 Jun;49(6):903-10. doi: 10.1007/s00127-013-0814-8. Epub 2014 Jan 9.

Abstract

PURPOSE

This study sought to investigate time to remission from depression in a community-based sample of adults followed for 12 years.

METHODS

Data were derived from the National Population Health Survey (1994/5-2006/7 and 1996/7-2008/9). Fully 1,128 adults were included who were depressed at baseline according to DSM-III/CIDI-SF criteria. Kaplan-Meier and Cox proportional hazards procedures were used to determine time to remission and the demographic (e.g., gender and marital status), psychosocial (e.g., social support and adverse childhood experience) and health-related (e.g., pain, health conditions and alcohol use) factors with which it is associated.

RESULTS

More than three quarters of the sample (77 %) no longer screened positive for depression at 2 years, and nearly the entire sample (94 %) had remitted by 12 years. Adverse childhood experiences (i.e., childhood abuse and parental additions), lack of social support, the presence of pain and health conditions (i.e., migraines, arthritis and back pain) each predicted more time to remission. The only factor associated with time to remission in the multivariate analysis was a history of childhood physical abuse.

CONCLUSIONS

Most community members with depression get better after 2 years and nearly all will have remitted, at least once, by 12 years. The results of this study may help guide the development of interventions for chronic depression that focus on early prevention of childhood abuse.

摘要

目的

本研究旨在调查在一个随访12年的社区成年样本中抑郁症缓解所需的时间。

方法

数据来源于全国人口健康调查(1994/5 - 2006/7和1996/7 - 2008/9)。共纳入了1128名根据DSM - III/CIDI - SF标准在基线时患有抑郁症的成年人。采用Kaplan - Meier法和Cox比例风险程序来确定缓解时间以及与之相关的人口统计学因素(如性别和婚姻状况)、心理社会因素(如社会支持和童年不良经历)和健康相关因素(如疼痛、健康状况和饮酒情况)。

结果

超过四分之三的样本(77%)在2年时不再筛查出抑郁症阳性,几乎整个样本(94%)在12年时已缓解。童年不良经历(即童年期受虐和父母离异)、缺乏社会支持、存在疼痛和健康状况(即偏头痛、关节炎和背痛)均预示着缓解所需时间更长。多变量分析中与缓解时间相关的唯一因素是童年期身体虐待史。

结论

大多数患有抑郁症的社区成员在2年后病情好转,几乎所有人在12年时至少会缓解一次。本研究结果可能有助于指导针对慢性抑郁症的干预措施的制定,这些措施侧重于早期预防童年期虐待。

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