Iverson Grant L, Gardner Andrew J
The Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston (Iverson); Spaulding Rehabilitation Hospital and Spaulding Research Institute, Boston (Iverson); the Sports Concussion Program, MassGeneral Hospital for Children, Boston (Iverson); Home Base, A Red Sox Foundation and Massachusetts General Hospital Program, Boston (Iverson); the Sports Concussion Program, Hunter New England Local Health District, New South Wales, Australia (Gardner); and the Centre for Stroke and Brain Injury, School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia (Gardner).
J Neuropsychiatry Clin Neurosci. 2020 Spring;32(2):139-146. doi: 10.1176/appi.neuropsych.19010021. Epub 2019 Oct 7.
In recent years, it has been proposed that depression represents one clinical subtype of chronic traumatic encephalopathy (CTE). This is the first study to examine the specificity of the research criteria for the clinical diagnosis of CTE in men with depression from the general population.
Data from the National Comorbidity Survey Replication, an in-person survey that examined the prevalence and correlates of mental disorders in the United States, were used for this study. Men diagnosed as having a major depressive episode in the past 30 days were included (N=101; mean age=39.4 years, SD=12.9, range=18-71). They were deemed to meet research criteriafor CTE if they presented with the purported supportive clinical features of CTE (e.g., impulsivity and substance abuse, anxiety, apathy, suicidality, and headache).
Approximately half of the sample (52.5%) met the proposed research criteria for CTE (i.e., traumatic encephalopathy syndrome). If one accepts the delayed-onset criterion as being present, meaning that the men in the sample were presenting with depression years after retirement from sports or the military, then 83.2% of this sample would meet the research criteria for diagnosis.
The clinical problems attributed to CTE, such as depression, suicidality, anxiety, anger control problems, and headaches, co-occurred in this sample of men with depression from the general population-illustrating that these problems are not specific or unique to CTE. More research is needed to determine whether depression is, in fact, a clinical subtype of CTE.
近年来，有人提出抑郁症是慢性创伤性脑病（CTE）的一种临床亚型。这是第一项研究，旨在检验CTE临床诊断研究标准对来自普通人群的抑郁症男性患者的特异性。
本研究使用了美国全国共病调查复制版的数据，该调查为面对面调查，研究了美国精神障碍的患病率及相关因素。纳入在过去30天内被诊断为患有重度抑郁发作的男性（N = 101；平均年龄 = 39.4岁，标准差 = 12.9，范围 = 18 - 71岁）。如果他们表现出CTE所谓的支持性临床特征（如冲动和药物滥用、焦虑、冷漠、自杀倾向和头痛），则被认为符合CTE的研究标准。
大约一半的样本（52.5%）符合CTE的拟议研究标准（即创伤性脑病综合征）。如果接受存在延迟发作标准，即样本中的男性在从体育或军队退役多年后出现抑郁症，那么该样本中83.2%的人将符合诊断的研究标准。
在来自普通人群的抑郁症男性样本中，归因于CTE的临床问题，如抑郁症、自杀倾向、焦虑、愤怒控制问题和头痛，同时出现——这表明这些问题并非CTE所特有或独有的。需要更多研究来确定抑郁症实际上是否是CTE的一种临床亚型。
