University Hospital of Lausanne, Lausanne, Switzerland.
General Practice and Primary Health Care Academic Centre, The University of Melbourne, Melbourne, Australia.
Soc Psychiatry Psychiatr Epidemiol. 2023 Aug;58(8):1179-1191. doi: 10.1007/s00127-023-02462-8. Epub 2023 Mar 23.
Previous population-based studies have partially provided inconsistent results regarding the co-variates of chronic depression, which were likely to be attributable to methodological limitations. The present paper that compared people with chronic major depressive disorder (MDD), non-chronic MDD and no mood disorder in the community focused on specific atypical and melancholic depression symptoms and subtypes of MDD, family history (FH) of mood disorders, measured physical cardio-vascular risk factors (CVRF), personality traits, coping style and adverse life-events.
Data stemmed from a population-based cohort including 3618 participants (female 53%, n=1918; mean age 50.9 years, s.d. 8.8 years). Among them 563 had a lifetime history of chronic MDD, 1060 of non-chronic MDD and 1995 of no mood disorder. Diagnostic and FH information were elicited through semi-structured interviews, CVRF were assessed through physical investigations.
The major findings were that chronic MDD was associated with increase in appetite/weight and suicidal ideation/attempts during the most severe episode, higher exposure to life-events in adulthood, higher levels of neuroticism, lower levels of extraversion and lower levels of informal help-seeking behavior but less frequent FH of MDD compared to non-chronic MDD.
Chronic MDD is associated with a series of potential modifiable risk factors which are accessible via psychotherapeutic approaches that may improve the course of chronic MDD.
之前基于人群的研究部分提供了关于慢性抑郁症共变因素的不一致结果,这可能归因于方法学上的局限性。本研究比较了社区中有慢性重度抑郁症(MDD)、非慢性 MDD 和无心境障碍的人群,重点关注特定的非典型和忧郁性抑郁症症状和 MDD 亚型、心境障碍家族史(FH)、测量的身体心血管风险因素(CVRF)、人格特质、应对方式和不良生活事件。
数据来自一个基于人群的队列,包括 3618 名参与者(女性 53%,n=1918;平均年龄 50.9 岁,标准差 8.8 岁)。其中 563 人有慢性 MDD 病史,1060 人有非慢性 MDD 病史,1995 人无心境障碍。通过半结构式访谈获得诊断和 FH 信息,通过身体检查评估 CVRF。
主要发现是慢性 MDD 与最严重发作期间食欲/体重增加和自杀意念/企图、成年期生活事件暴露增加、神经质水平升高、外向性水平降低、非正式求助行为水平降低有关,但心境障碍 FH 频率低于非慢性 MDD。
慢性 MDD 与一系列潜在的可改变风险因素有关,这些因素可通过心理治疗方法来改善慢性 MDD 的病程。