Judd L L, Rapaport M H, Paulus M P, Brown J L
San Diego Psychopharmacology Research Program, Department of Psychiatry, University of California, La Jolla 92093-0603.
J Clin Psychiatry. 1994 Apr;55 Suppl:18-28.
Secondary analyses in a subsample (N = 9160) of the National Institute of Mental Health Epidemiologic Catchment Area Program data base revealed that 19.6% of the general population reported one or more depressive symptoms in the previous month. One-year prevalence of two or more depressive symptoms in the general population was 11.8%, a prevalence figure exceeding the 9.5% 1-year prevalence for all the DSM-III mood disorders combined. We have labeled this potential clinical condition as subsyndromal symptomatic depression (SSD), defining it as any two or more simultaneous symptoms of depression, present for most or all of the time, at least 2 weeks in duration, associated with evidence of social dysfunction, occurring in individuals who do not meet criteria for diagnoses of minor depression, major depression, and/or dysthymia. SSD has a 1-year prevalence in the general population of 8.4%, two thirds of whom are women (63.4%). The most common SSD symptoms reported are insomnia (44.7%), feeling tired out all the time (42.1%), recurrent thoughts of death (31.0%), trouble concentrating (22.7%), significant weight gain (18.5%), slowed thinking (15.1%), and hypersomnia (15.1%). Increased prevalence of disability and welfare benefits was found in SSD as compared with respondents with no depressive symptoms. SSD represents a significant clinical population not covered by any DSM-III, DSM-III-R, or DSM-IV mood disorder diagnosis. Since SSD is also associated with significant increases in social dysfunction and disability, we feel there is good evidence to conclude that SSD is an unrecognized clinical condition of considerable public health importance that is deserving of further characterization and study.
对美国国立精神卫生研究所流行病学集水区项目数据库的一个子样本（N = 9160）进行的二次分析显示，19.6%的普通人群报告在前一个月出现了一种或多种抑郁症状。普通人群中两种或更多抑郁症状的一年患病率为11.8%，这一患病率超过了所有DSM - III情绪障碍合并后的9.5%的一年患病率。我们将这种潜在的临床状况标记为亚综合征性症状性抑郁症（SSD），将其定义为任何两种或更多同时出现的抑郁症状，大部分或全部时间存在，持续至少2周，伴有社会功能障碍的证据，发生在不符合轻度抑郁症、重度抑郁症和/或心境恶劣诊断标准的个体中。SSD在普通人群中的一年患病率为8.4%，其中三分之二为女性（63.4%）。报告的最常见的SSD症状是失眠（44.7%）、总是感到疲惫（42.1%）、反复出现死亡念头（31.0%）、注意力难以集中（22.7%）、体重显著增加（18.5%）、思维迟缓（15.1%）和嗜睡（15.1%）。与没有抑郁症状的受访者相比，SSD患者中残疾和福利津贴的患病率增加。SSD代表了一个未被任何DSM - III、DSM - III - R或DSM - IV情绪障碍诊断所涵盖的重要临床群体。由于SSD也与社会功能障碍和残疾的显著增加相关，我们认为有充分的证据可以得出结论，SSD是一种未被认识到的具有相当公共卫生重要性的临床状况，值得进一步描述和研究。
