Wittchen H U, Knäuper B, Kessler R C
Max Planck Institute of Psychiatry, München, Germany.
Br J Psychiatry Suppl. 1994 Dec(26):16-22.
Over the past decade, major epidemiological studies have been conducted to determine the prevalence of depressive syndromes, primarily major depression or dysthymia. The highest prevalences occur in younger cohorts (18-29 years); considerably lower prevalences are found in older individuals (45 years and above), with the lowest in those aged 65 and older. Several studies have confirmed an increase in the cumulative lifetime estimates of major depression in successively younger birth cohorts during this century. At the same time, questions have been raised about the low prevalence of depression in the elderly, including the role of confounding factors (e.g. differential morbidity and response-biased memory). Standardised diagnostic assessment procedures may be insufficiently adapted for use in the elderly. It has also been recognised that a substantial number of elderly individuals suffer from clinically relevant symptoms of depression but do not meet the criteria for major depression. Future research will be required to elucidate fully the apparently changing rates of depression.
在过去十年中，人们开展了多项主要的流行病学研究，以确定抑郁综合征的患病率，主要是重度抑郁症或心境恶劣障碍。患病率最高的是较年轻的人群（18 - 29岁）；在年龄较大的个体（45岁及以上）中患病率显著较低，而在65岁及以上的人群中患病率最低。多项研究证实，在本世纪中，出生队列越年轻，重度抑郁症的累积终生估计患病率越高。与此同时，人们对老年人抑郁症患病率较低提出了质疑，包括混杂因素（如发病率差异和记忆偏差反应）的作用。标准化诊断评估程序可能不太适合用于老年人。人们还认识到，相当多的老年人患有临床上相关的抑郁症状，但不符合重度抑郁症的标准。未来需要开展研究以充分阐明明显变化的抑郁症发病率。
