Ingham J G, Kreitman N B, Miller P M, Sashidharan S P, Surtees P G
University Department of Psychiatry, Royal Edinburgh Hospital.
Br J Psychiatry. 1987 Nov;151:643-51. doi: 10.1192/bjp.151.5.643.
Depressive illness is known to be associated with low self-evaluation, but it has been suggested that there may be a reciprocal connection as well, such that low self-appraisal (in the absence of illness) makes the subsequent onset of depression more likely. A prospective study, using a community sample of 376 women, provided data about clinical state over a period of 18 months, and self-appraisal questionnaire scores were determined on two occasions separated by 6 months. There was no evidence that low self-evaluation predicted future episodes of depressive illness, except in women who reported previous psychological episodes for which they had sought medical help, and, even for those with previous episodes, much of the predictive power of low self-esteem was accounted for by individuals who were subsequently recognised to have been in the early stages of illness. Conversely, there was little evidence that prior episodes predicted future illness in people with high self-esteem. One explanation of the findings is that recurrent episodes of illness cause progressive impairment of self-appraisal, but other possibilities are also considered. Women who had recovered from illnesses detected at the first interview still had significantly less self-confidence 6 months later than those who were well throughout.
众所周知，抑郁症与自我评价低有关，但也有人认为可能还存在一种相互关联，即低自我评价（在无疾病的情况下）会使随后患抑郁症的可能性增加。一项前瞻性研究以376名女性为社区样本，提供了18个月期间的临床状态数据，并在两次间隔6个月的时间点测定了自我评价问卷得分。没有证据表明低自我评价能预测未来的抑郁发作，除了那些报告曾因心理问题寻求过医疗帮助的女性，而且，即使对于那些有过既往发作的女性，低自尊的预测能力也大多由后来被认定处于疾病早期阶段的个体所解释。相反，几乎没有证据表明既往发作能预测高自尊者未来患病情况。对这些发现的一种解释是，疾病的反复发作会导致自我评价的逐渐受损，但也考虑了其他可能性。在首次访谈中被检测出患病的女性，6个月后仍比自始至终都健康的女性自信心明显更低。
