Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany/NeuroCure Clinical Research Center, Charité-Universitätsmedizin Berlin, Berlin, Germany.
NeuroCure Clinical Research Center, Charité-Universitätsmedizin Berlin, Berlin, Germany/Experimental and Clinical Research Center, Charité-Universitätsmedizin Berlin and Max Delbrück Center for Molecular Medicine, Berlin, Germany.
Mult Scler. 2016 Oct;22(11):1476-1484. doi: 10.1177/1352458515622826. Epub 2016 Jan 8.
Depression is a common co-morbidity in patients with multiple sclerosis (MS). While somatic symptoms of MS correlate with depression levels, it is unclear whether the clinical presentation of MS-associated depression differs from patients with "idiopathic" major depressive disorder (MDD).
To compare the clinical phenotype of depression among MS and idiopathic MDD patients.
Mean relative contribution of individual Beck Depression Inventory-II (BDI-II) items was evaluated among n = 139 patients with relapsing-remitting MS and n = 85 MDD patients without somatic illness. Next, comparisons were repeated in n = 38 MS with clinically relevant depressive symptoms (BDI-II > 19) and n = 38 MDD patients matched for sex, age, and depression severity. Finally, the underlying construct of depression was compared across groups using confirmatory factor analysis (CFA).
Comparisons on a whole-group level produced the expected differences along somatic/non-somatic symptoms. However, when appropriately controlling for depression severity, age, and sex, only four items contributed differentially to BDI-II total scores in MS versus MDD. CFA suggested that the underlying depression construct is essentially identical in both groups.
The clinical phenotype of "idiopathic" MDD and MS-associated depression appears similar when adequately examined. The relevance of these findings for psychotherapeutic approaches for MS-associated depression should be explored in future studies.
抑郁症是多发性硬化症（MS）患者常见的合并症。虽然 MS 的躯体症状与抑郁水平相关，但 MS 相关抑郁的临床表现是否与“特发性”重性抑郁障碍（MDD）患者不同尚不清楚。
比较 MS 和特发性 MDD 患者抑郁的临床表型。
评估了 n=139 例复发缓解型 MS 患者和 n=85 例无躯体疾病的 MDD 患者的贝克抑郁量表第二版（BDI-II）个体项目的平均相对贡献。接下来，在 n=38 例具有临床相关抑郁症状（BDI-II>19）的 MS 患者和 n=38 例性别、年龄和抑郁严重程度匹配的 MDD 患者中重复了比较。最后，使用验证性因子分析（CFA）比较了各组的抑郁潜在结构。
在全组水平上的比较产生了预期的躯体/非躯体症状差异。然而，当适当控制抑郁严重程度、年龄和性别时，只有四个项目在 MS 与 MDD 之间对 BDI-II 总分有差异贡献。CFA 表明，两组的抑郁潜在结构基本相同。
在充分检查时，“特发性”MDD 和 MS 相关抑郁的临床表型似乎相似。未来的研究应探讨这些发现对 MS 相关抑郁的心理治疗方法的相关性。
