Fried E I, Nesse R M, Guille C, Sen S
Faculty of Psychology and Educational Sciences, University of Leuven, Leuven, Belgium.
School of Life Sciences, Arizona State University, Tempe, AZ, USA.
Acta Psychiatr Scand. 2015 Jun;131(6):465-71. doi: 10.1111/acps.12395. Epub 2015 Feb 4.
Life stress consistently increases the incidence of major depression. Recent evidence has shown that individual symptoms of major depressive disorder (MDD) differ in important dimensions such as their genetic and etiological background, but the impact of stress on individual MDD symptoms is not known. Here, we assess whether stress affects depression symptoms differentially.
We used the chronic stress of medical internship to examine changes of the nine Diagnostic and Statistical Manual (DSM)-5 criterion symptoms for depression in 3021 interns assessed prior to and throughout internship.
All nine depression symptoms increased in response to stress (all P < 0.001), on average by 173%. Symptom increases differed substantially from each other (P < 0.001), with psychomotor problems (289%) and interest loss (217%) showing the largest increases, and suicidal ideation (146%) and sleep problems (52%) the smallest. Symptoms also differed in their severities under stress (P < 0.001): Fatigue, appetite problems and sleep problems were most prevalent; psychomotor problems and suicidal ideation were least prevalent.
Stress differentially affects the DSM-5 depressive symptoms. Analyses of individual symptoms reveal important insights obfuscated by sum-scores.
生活压力持续增加重度抑郁症的发病率。最近的证据表明，重度抑郁症（MDD）的个体症状在重要方面存在差异，如遗传和病因背景，但压力对个体MDD症状的影响尚不清楚。在此，我们评估压力是否对抑郁症状有不同影响。
我们利用医学实习的慢性压力，研究了3021名实习生在实习前及实习期间评估的九种《精神疾病诊断与统计手册》（DSM）-5抑郁标准症状的变化。
所有九种抑郁症状均因压力而增加（所有P<0.001），平均增加173%。症状增加彼此间差异很大（P<0.001），其中精神运动问题（289%）和兴趣丧失（217%）增加幅度最大，自杀意念（146%）和睡眠问题（52%）增加幅度最小。症状在压力下的严重程度也存在差异（P<0.001）：疲劳、食欲问题和睡眠问题最为普遍；精神运动问题和自杀意念最不普遍。
压力对DSM-5抑郁症状有不同影响。对个体症状的分析揭示了总分掩盖的重要见解。
