Taquet Maxime, Quoidbach Jordi, Gross James J, Saunders Kate E A, Goodwin Guy M
Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, United Kingdom.
Department of People Management and Organisation, ESADE (Escuela Superior de Administración y Dirección de Empresas) Business School, Barcelona, Spain.
JAMA Psychiatry. 2020 Sep 1;77(9):944-951. doi: 10.1001/jamapsychiatry.2020.0588.
Existing therapeutic options are insufficient to tackle the disease burden of depression, and new treatments are sorely needed. Defining new psychotherapeutic targets is challenging given the paucity of coherent mechanistic explanations for depression.
To assess whether mood homeostasis (ie, the stabilization of one's mood by engaging in mood-modifying activities) is a possible new therapeutic target by testing the hypothesis that people with low (vs high) mean mood and people with (vs without) a history of depression have impaired mood homeostasis.
DESIGN, SETTING, AND PARTICIPANTS: The quantitative association between mood and daily activities was computed in 2 large case-control studies based on the 58sec data set (collected from December 1, 2012, to May 31, 2014, and analyzed from April 1 to 30, 2019), and the World Health Organization Study on Global Aging and Adult Health (WHO SAGE) data set (collected from January 1, 2007, to December 31, 2010, and analyzed from June 1 to 30, 2019). The 58sec data set consists of self-enrolled participants from high-income countries. The WHO SAGE data set consists of nationally representative participants in low- and middle-income countries recruited via cluster sampling.
The main outcome (defined before data analysis) was the difference in mood homeostasis between people with high vs low mean mood (58sec data) and between people with vs without a history of depression (WHO SAGE data).
A total of 28 212 participants from the 58sec data set (65.8% female; mean [SD] age, 28.1 [9.0] years) and 30 116 from the WHO SAGE data set (57.0% female; mean [SD] age, 57.8 [14.7] years) were included, for an overall study population of 58 328 participants. Mood homeostasis was significantly lower in people with low (vs high) mean mood (0.63 [95% CI, 0.45 to 0.79] vs 0.96 [95% CI, 0.96 to 0.98]; P < .001) and in people with (vs without) a history of depression (0.03 [95% CI, -0.26 to 0.24] vs 0.68 [95% CI, 0.55 to 0.75]; P < .001). In dynamic simulations, lower mood homeostasis led to more depressive episodes (11.8% vs 3.8% yearly risk; P < .001) that lasted longer (4.19 vs 2.90 weeks; P = .006).
In this study, mood homeostasis appeared to have been impaired in people with low mood and in those with a history of depression. Mood homeostasis may therefore provide new insights to guide the development of treatments for depression.
现有的治疗方案不足以应对抑郁症的疾病负担，因此迫切需要新的治疗方法。鉴于对抑郁症缺乏连贯的机制解释，确定新的心理治疗靶点具有挑战性。
通过检验以下假设来评估情绪稳态（即通过参与改变情绪的活动来稳定情绪）是否是一个可能的新治疗靶点：平均情绪较低（与较高）的人以及有（与无）抑郁症病史的人存在情绪稳态受损。
设计、设置和参与者：在两项大型病例对照研究中，根据58秒数据集（收集于2012年12月1日至2014年5月31日，并于2019年4月1日至30日进行分析）和世界卫生组织全球老龄化与成人健康研究（WHO SAGE）数据集（收集于2007年1月1日至2010年12月31日，并于2019年6月1日至30日进行分析）计算情绪与日常活动之间的定量关联。58秒数据集由来自高收入国家的自报名参与者组成。WHO SAGE数据集由通过整群抽样招募的低收入和中等收入国家具有全国代表性的参与者组成。
主要结局（在数据分析前定义）是平均情绪较高与较低的人（58秒数据集）之间以及有与无抑郁症病史的人（WHO SAGE数据集）之间情绪稳态的差异。
58秒数据集中共有28212名参与者（65.8%为女性；平均[标准差]年龄为28.1[9.0]岁），WHO SAGE数据集中有30116名参与者（57.0%为女性；平均[标准差]年龄为57.8[14.7]岁），总研究人群为58328名参与者。平均情绪较低（与较高）的人（0.63[95%置信区间，0.45至0.79]对0.96[95%置信区间，0.96至0.98]；P < .001）以及有（与无）抑郁症病史的人（0.03[95%置信区间，-0.26至0.24]对0.68[95%置信区间，0.55至0.75]；P < .001）的情绪稳态显著较低。在动态模拟中，较低的情绪稳态导致更多的抑郁发作（年风险为11.8%对3.8%；P < .001），且持续时间更长（4.19对2.90周；P = .006）。
在本研究中，情绪较低的人和有抑郁症病史的人似乎存在情绪稳态受损。因此，情绪稳态可能为指导抑郁症治疗的发展提供新的见解。
