Wells K B, Stewart A, Hays R D, Burnam M A, Rogers W, Daniels M, Berry S, Greenfield S, Ware J
RAND Corp, Santa Monica, CA 90406-2138.
JAMA. 1989 Aug 18;262(7):914-9.
We describe the functioning and well-being of patients with depression, relative to patients with chronic medical conditions or no chronic conditions. Data are from 11,242 outpatients in three health care provision systems in three US sites. Patients with either current depressive disorder or depressive symptoms in the absence of disorder tended to have worse physical, social, and role functioning, worse perceived current health, and greater bodily pain than did patients with no chronic conditions. The poor functioning uniquely associated with depressive symptoms, with or without depressive disorder, was comparable with or worse than that uniquely associated with eight major chronic medical conditions. For example, the unique association of days in bed with depressive symptoms was significantly greater than the comparable association with hypertension, diabetes, and arthritis. Depression and chronic medical conditions had unique and additive effects on patient functioning.
我们描述了抑郁症患者相对于患有慢性疾病或无慢性疾病患者的功能状况和幸福感。数据来自美国三个地点的三个医疗保健提供系统中的11242名门诊患者。患有当前抑郁症或无疾病但有抑郁症状的患者,与无慢性疾病的患者相比,往往在身体、社交和角色功能方面更差,对当前健康状况的感知更差,身体疼痛更严重。与有或无抑郁症的抑郁症状独特相关的功能不良,与与八种主要慢性疾病独特相关的功能不良相当或更差。例如,卧床天数与抑郁症状的独特关联显著大于与高血压、糖尿病和关节炎的可比关联。抑郁症和慢性疾病对患者功能有独特的累加效应。