Markkula Niina, Marola Niko, Nieminen Tarja, Koskinen Seppo, Saarni Samuli I, Härkänen Tommi, Suvisaari Jaana
National Institute for Health and Welfare, Department of Mental Health and Substance Abuse Services, Helsinki, Finland; Universidad del Desarrollo, Santiago, Chile.
National Institute for Health and Welfare, Department of Mental Health and Substance Abuse Services, Helsinki, Finland.
J Affect Disord. 2017 Jan 15;208:255-264. doi: 10.1016/j.jad.2016.08.051. Epub 2016 Oct 18.
Identifying risk factors for depression is important for understanding etiological mechanisms and targeting preventive efforts. No prior studies have compared risk factors of dysthymia and major depressive disorder (MDD) in a longitudinal setting.
Predictors of new-onset MDD and dysthymia were examined in a longitudinal general population study (Health 2000 and 2011 Surveys, BRIF8901). 4057 persons free of depressive disorders at baseline were followed up for 11 years. DSM-IV MDD and dysthymia were diagnosed with the Composite International Diagnostic Interview.
126 persons (4.4%, 95%CI 3.6-5.2) were diagnosed with MDD or dysthymia at follow-up. Predictors of new-onset depressive disorders were younger age (adjusted OR 0.97, 95%CI 0.95-0.99 per year), female gender (aOR 1.46, 95%CI 1.01-2.12), multiple childhood adversities (aOR 1.76, 95%CI 1.10-2.83), low trust dimension of social capital (aOR 0.58, 95%CI 0.36-0.96 for high trust), baseline anxiety disorder (aOR 2.75, 95%CI 1.36-5.56), and baseline depressive symptoms (aOR 1.65, 95%CI 1.04-2.61 for moderate and aOR 2.49, 95%CI 1.20-5.17 for severe symptoms). Risk factors for MDD were younger age, female gender, anxiety disorder and depressive symptoms, whereas younger age, multiple childhood adversities, low trust, and having 1-2 somatic diseases predicted dysthymia.
We only had one follow-up point at eleven years, and did not collect information on the subjects' health during the follow-up period.
Persons with subclinical depressive symptoms, anxiety disorders, low trust, and multiple childhood adversities have a higher risk of depressive disorders. Predictors of MDD and dysthymia appear to differ. This information can be used to target preventive efforts and guide social policies.
识别抑郁症的风险因素对于理解病因机制和开展预防工作至关重要。此前尚无研究在纵向研究中比较心境恶劣障碍和重度抑郁症（MDD）的风险因素。
在一项纵向的普通人群研究（2000年和2011年健康调查，BRIF8901）中，对新发MDD和心境恶劣障碍的预测因素进行了研究。对4057名基线时无抑郁症的人进行了11年的随访。采用复合国际诊断访谈对DSM-IV MDD和心境恶劣障碍进行诊断。
126人（4.4%，95%可信区间3.6 - 5.2）在随访时被诊断为MDD或心境恶劣障碍。新发抑郁症的预测因素包括年龄较小（校正后比值比0.97，每年95%可信区间0.95 - 0.99）、女性（校正后比值比1.46，95%可信区间1.01 - 2.12）、童年时期的多种逆境（校正后比值比1.76，95%可信区间1.10 - 2.83）、社会资本中信任维度较低（高信任者校正后比值比0.58，95%可信区间0.36 - 0.96）、基线焦虑症（校正后比值比2.75，95%可信区间1.36 - 5.56）以及基线抑郁症状（中度症状校正后比值比1.65，95%可信区间1.04 - 2.61；重度症状校正后比值比2.49，95%可信区间1.20 - 5.17）。MDD的风险因素包括年龄较小、女性、焦虑症和抑郁症状，而年龄较小、童年时期的多种逆境、信任度低以及患有1 - 2种躯体疾病则是心境恶劣障碍的预测因素。
我们仅在11年时有一个随访点，且未收集随访期间受试者的健康信息。
有亚临床抑郁症状、焦虑症、信任度低和童年时期多种逆境的人患抑郁症的风险较高。MDD和心境恶劣障碍的预测因素似乎有所不同。这些信息可用于指导预防工作和社会政策。
