Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria.
Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy.
J Affect Disord. 2021 May 1;286:149-157. doi: 10.1016/j.jad.2021.02.070. Epub 2021 Mar 5.
While the association between relationship status and the development of depressive symptoms in the general population were reported previously, its relation to the severity and the course of major depressive disorder (MDD) as well as the treatment patterns and response rates needs to be elucidated.
The present international multicenter cross-sectional study performed by the European Group for the Study of Resistant Depression (GSRD) investigated socio-demographic and clinical patterns of relationship status in a real-world sample of 1410 adult in- and outpatients with MDD as primary diagnosis.
While 49.9% of all MDD patients were partnered, 25.4% were separated, and 24.8% were single. Single relationship status was linked to younger mean age, earlier mean age of onset, and current suicidal risk. Being separated was related to older mean age, unemployment, greater symptom severity, current suicidal risk, and add-on treatment strategies. Partnered relationship status was associated with less frequent current suicidal risk.
The retrospective assessment of treatment response that was exclusively based on psychopharmacotherapeutic strategies should be critically considered and weighed while interpreting the present results providing novel insights into the complex interaction of relationship status with the clinical phenotype of MDD.
Although MDD patients living in relationships do not seem to be omitted from the evolution of MDD, they may be spared from chronicity and suicidality. Hence, being aware of the current relationship status might support clinicians in the diagnostic and therapeutic process towards optimized management of such challenging clinical phenomena and their negative consequences.
虽然之前有报道过人际关系状况与普通人群中抑郁症状发展之间的关系,但它与重度抑郁症(MDD)的严重程度和病程以及治疗模式和反应率的关系仍需要阐明。
本研究由欧洲难治性抑郁症研究组(GSRD)进行的国际多中心横断面研究,调查了 1410 名成年 MDD 门诊和住院患者真实样本中人际关系状况的社会人口学和临床模式,这些患者的主要诊断均为 MDD。
所有 MDD 患者中,49.9%的患者处于伴侣关系中,25.4%的患者处于分居状态,24.8%的患者处于单身状态。单身的人际关系状况与较年轻的平均年龄、较早的平均发病年龄和当前的自杀风险相关。分居与较年长的平均年龄、失业、更大的症状严重程度、当前的自杀风险和附加的治疗策略相关。伴侣关系与当前自杀风险的频率较低有关。
在解释目前的结果时,应该批判性地考虑和权衡仅基于精神药理学治疗策略的治疗反应的回顾性评估,这为关系状况与 MDD 的临床表型之间的复杂相互作用提供了新的见解。
尽管处于伴侣关系中的 MDD 患者似乎并没有从 MDD 的发展中被遗漏,但他们可能不会变得慢性和具有自杀倾向。因此,了解当前的人际关系状况可能有助于临床医生在诊断和治疗过程中优化对这些具有挑战性的临床现象及其负面后果的管理。