1 University of Massachusetts Medical School, Worcester, MA, USA.
2 Temple University College of Public Health, Philadelphia, PA, USA.
Am J Mens Health. 2018 Jan;12(1):5-13. doi: 10.1177/1557988315607297. Epub 2015 Oct 5.
The burden of depression in men is high. Current diagnostic criteria may not fully capture men's experience with depression. Descriptions of the heterogeneity in depression among men are lacking. The purpose of the study was to characterize latent subtypes of major depression and changes in these subtypes among men receiving citalopram in Level 1 of the Sequenced Treatment Alternatives to Relieve Depression (STARD) trial. Latent transition analysis was applied to data from 387 men who completed baseline and Week 12 study visits in Level 1 of STARD. Items from the self-report version of the Quick Inventory of Depressive Symptomatology were used as indicators of latent depression subtypes. Four statuses were identified at baseline and Week 12. Baseline statuses were Mild (10% of men), Moderate (53%), Severe with Psychomotor Slowing (20%), and Severe with Psychomotor Agitation (17%). At Week 12, the statuses were Symptom Resolution (41%), Mild (36%), Moderate (18%), and Severe with Psychomotor Slowing (5%). Men in the Mild status were most likely to transition to Symptom Resolution (probability = 69%). Men in the Severe with Agitation status were least likely to transition to Symptom Resolution (probability = 0%). This work highlights the need to not focus solely on summary rating scores but to also consider patterns of symptoms when treating depression.
男性的抑郁负担很高。目前的诊断标准可能无法充分捕捉男性的抑郁体验。缺乏对男性抑郁异质性的描述。本研究的目的是描述接受西酞普兰治疗的男性中重度抑郁症的潜在亚群，并描述这些亚群在 STARD 试验一级治疗中的变化。潜在转变分析应用于在 STARD 一级完成基线和第 12 周研究访问的 387 名男性的数据。从自我报告版抑郁症状快速清单中提取项目作为潜在抑郁亚群的指标。在基线和第 12 周确定了 4 种状态。基线状态为轻度（10%的男性）、中度（53%）、伴有精神运动迟缓的重度（20%）和伴有精神运动激越的重度（17%）。在第 12 周，状态分别为症状缓解（41%）、轻度（36%）、中度（18%）和伴有精神运动迟缓的重度（5%）。处于轻度状态的男性最有可能转变为症状缓解（概率=69%）。处于伴有激越的重度状态的男性最不可能转变为症状缓解（概率=0%）。这项工作强调不仅要关注综合评分，还要在治疗抑郁症时考虑症状模式。
