Martin-Key Nayra A, Olmert Tony, Barton-Owen Giles, Han Sung Yeon Sarah, Cooper Jason D, Eljasz Pawel, Farrag Lynn P, Friend Lauren V, Bell Emily, Cowell Dan, Tomasik Jakub, Bahn Sabine
Department of Chemical Engineering and Biotechnology, University of Cambridge, Cambridge, UK.
Psyomics Ltd, Cambridge, UK.
Brain Behav. 2021 Jun;11(6):e02167. doi: 10.1002/brb3.2167. Epub 2021 May 7.
The Delta Study was undertaken to improve the diagnosis of mood disorders in individuals presenting with low mood. The current study aimed to estimate the prevalence and explore the characteristics of mood disorders in participants of the Delta Study, and discuss their implications for clinical practice.
Individuals with low mood (Patients Health Questionnaire-9 score ≥5) and either no previous mood disorder diagnosis (baseline low mood group, n = 429), a recent (≤5 years) clinical diagnosis of MDD (baseline MDD group, n = 441) or a previous clinical diagnosis of BD (established BD group, n = 54), were recruited online. Self-reported demographic and clinical data were collected through an extensive online mental health questionnaire and mood disorder diagnoses were determined with the World Health Organization Composite International Diagnostic Interview (CIDI).
The prevalence of BD and MDD in the baseline low mood group was 24% and 36%, respectively. The prevalence of BD among individuals with a recent diagnosis of MDD was 31%. Participants with BD in both baseline low mood and baseline MDD groups were characterized by a younger age at onset of the first low mood episode, more severe depressive symptoms and lower wellbeing, relative to the MDD or low mood groups. Approximately half the individuals with BD diagnosed as MDD (49%) had experienced (hypo)manic symptoms prior to being diagnosed with MDD.
The current results confirm high under- and misdiagnosis rates of mood disorders in individuals presenting with low mood, potentially leading to worsening of symptoms and decreased well-being, and indicate the need for improved mental health triage in primary care.
开展Delta研究以改善对情绪低落个体的心境障碍诊断。本研究旨在估计Delta研究参与者中心境障碍的患病率并探索其特征，并讨论这些特征对临床实践的意义。
情绪低落（患者健康问卷-9得分≥5）且既往无心境障碍诊断（基线情绪低落组，n = 429）、近期（≤5年）有重度抑郁障碍临床诊断（基线重度抑郁障碍组，n = 441）或既往有双相障碍临床诊断（确诊双相障碍组，n = 54）的个体通过网络招募。通过一份广泛的在线心理健康问卷收集自我报告的人口统计学和临床数据，并使用世界卫生组织综合国际诊断访谈（CIDI）确定心境障碍诊断。
基线情绪低落组中双相障碍和重度抑郁障碍的患病率分别为24%和36%。近期诊断为重度抑郁障碍的个体中双相障碍的患病率为31%。与重度抑郁障碍或情绪低落组相比，基线情绪低落组和基线重度抑郁障碍组中的双相障碍参与者具有首次情绪低落发作年龄较小、抑郁症状更严重和幸福感较低的特征。约一半被诊断为重度抑郁障碍的双相障碍个体（49%）在被诊断为重度抑郁障碍之前经历过（轻）躁狂症状。
目前的结果证实了情绪低落个体中心境障碍的漏诊和误诊率很高，这可能导致症状恶化和幸福感下降，并表明初级保健中需要改进心理健康分诊。
