Sage Therapeutics, Inc., Cambridge, Massachusetts.
National Alliance on Mental Illness (NAMI), Arlington, Virginia.
J Clin Psychiatry. 2022 Oct 19;83(6):21r14328. doi: 10.4088/JCP.21r14328.
To summarize the breadth of data exploring the relationship between major depressive disorder (MDD) and both the incidence and the disease course of a range of comorbidities. The authors searched MEDLINE, Embase, PsycINFO, Cochrane Database of Systematic Reviews, and several prespecified congresses. Searches included terms related to MDD and several comorbidity categories, restricted to those published in the English language from 2005 onward. Eligibility criteria included observational studies within North America and Europe that examined the covariate-adjusted impact of MDD on the risk and/or severity of comorbidities. A total of 6,811 articles were initially identified for screening. : Two investigators extracted data and assessed study quality. In total, 199 articles were included. Depression was significantly ( < .05) associated with an increased incidence of dementia and Alzheimer's disease as well as cognitive decline in individuals with existing disease; increased incidence and worsening of cardiovascular disease/events (although mixed results were found for stroke); worsening of metabolic syndrome; increased incidence of diabetes, particularly among men, and worsening of existing diabetes; increased incidence of obesity, particularly among women; increased incidence and worsening of certain autoimmune diseases; increased incidence and severity of HIV/AIDS; and increased incidence of drug abuse and severity of both alcohol and drug abuse. The presence of MDD was identified as a risk factor for both the development and the worsening of a range of comorbidities. These results highlight the importance of addressing depression early in its course and the need for integrating mental and general health care.
总结了广泛的数据，探索了重度抑郁症（MDD）与一系列合并症的发生率和疾病进程之间的关系。作者检索了 MEDLINE、Embase、PsycINFO、Cochrane 系统评价数据库和几个预先指定的会议。检索词包括与 MDD 和几种合并症类别相关的术语，并限制在 2005 年以后以英文发表的研究。纳入标准包括在北美和欧洲进行的观察性研究，这些研究检查了 MDD 对合并症风险和/或严重程度的协变量调整影响。最初确定了 6811 篇文章进行筛选。两名研究人员提取数据并评估了研究质量。共有 199 篇文章入选。抑郁与痴呆和阿尔茨海默病的发生率增加以及现有疾病患者的认知能力下降显著相关（ < .05）；心血管疾病/事件的发生率和恶化增加（尽管对中风的结果存在差异）；代谢综合征恶化；糖尿病的发生率增加，特别是男性，以及现有糖尿病的恶化；肥胖的发生率增加，特别是女性；某些自身免疫性疾病的发生率和严重程度增加；艾滋病毒/艾滋病的发生率和严重程度增加；药物滥用的发生率和酒精和药物滥用的严重程度增加。MDD 的存在被确定为一系列合并症发展和恶化的危险因素。这些结果强调了在疾病早期早期治疗抑郁的重要性，以及需要整合精神和一般保健的必要性。
