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阈下抑郁的概念、操作性定义和流行病学数据。范围综述。

Subthreshold depression - concept, operationalisation and epidemiological data. A scoping review.

机构信息

Hospital for Psychiatry, Psychotherapy und Psychosomatic Medicine Schloss Werneck, Werneck, Germany.

Center of Brain Research, Medical University of Vienna, Vienna, Austria.

出版信息

Int J Psychiatry Clin Pract. 2023 Mar;27(1):92-106. doi: 10.1080/13651501.2022.2087530. Epub 2022 Jun 23.

Abstract

PURPOSE

In diagnostic systems (e.g., DSM-5, ICD-10), depression is defined categorically. However, the concept of subthreshold depression (SD) has gained increasing interest in recent years. The purpose of the present paper was to review, based on a scoping review, the relevant papers in this field published between October 2011 and September 2020.

MATERIALS AND METHODS

Of the 1,160 papers identified, 64 records could be included in further analysis. The scoping review was conducted using both electronic and manual methods.

RESULTS

The main result of the analysis is that the operationalisation criteria used are highly heterogeneous, which also leads to very heterogenous epidemiological data.

CONCLUSIONS

Clear conclusions are not possible scrutinising the reported results. Most definitions seem to be arbitrary, with considerable overlap (e.g., between SD and minor depression). The review also revealed that the impact of SD on quality of life and related parameters appear to be in the range of the respective impact of major depression (MD) and therapeutic approaches might be helpful for SD and also for the prevention of conversion from SD to MD. Keeping the presented difficulties in mind, a proposal for the definition of SD is made in the present paper in order to facilitate the discussion leading to more homogeneous criteria.

摘要

目的

在诊断系统(例如,DSM-5、ICD-10)中,抑郁被分类定义。然而,近年来阈下抑郁(SD)的概念引起了越来越多的关注。本文旨在通过范围综述,回顾 2011 年 10 月至 2020 年 9 月期间发表的该领域的相关论文。

材料和方法

在确定的 1160 篇论文中,有 64 篇记录可进一步分析。范围综述采用电子和手动方法进行。

结果

分析的主要结果是,所使用的操作化标准高度异质,这也导致了非常异质的流行病学数据。

结论

仔细审查报告的结果,无法得出明确的结论。大多数定义似乎是任意的,有相当大的重叠(例如,SD 和轻度抑郁之间)。综述还表明,SD 对生活质量和相关参数的影响似乎与重度抑郁(MD)的影响相当,治疗方法可能对 SD 以及预防 SD 向 MD 的转化有帮助。考虑到所呈现的困难,本文提出了 SD 的定义建议,以促进讨论,达成更同质的标准。

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