Olié J P, Levy-Attar D
Centre Hospitalier Sainte-Anne, Paris.
Encephale. 1993 Jul;19 Spec No 2:379-91.
Can depression still be defined today as a transient abnormal state which is reversible with treatment? Chronic depression affects about one out of five depressed subjects. The progression to chronicity has a multifactorial determinism; it includes sociodemographic, medical and psychopathological parameters. These depressions are sometimes difficult to diagnose, all the more as there are no definitely established nosographic criteria. One usually considered is the persistence over more than two years of depressive symptoms and/or of socioprofessional dysfunctions. First-line treatment is based on uninterrupted prescription of a well-tolerated antidepressant for over two years, with dosage maintained at the acute phase level. In the event of a failure, there is as yet no well-defined alternative therapy. Because of their socioprofessional repercussions, chronic depressions may become a significant public health issue. They need imperiously that prospective long-term evaluation studies be implemented.
如今，抑郁症还能被定义为一种通过治疗可逆转的短暂异常状态吗？慢性抑郁症影响着约五分之一的抑郁症患者。发展为慢性抑郁症具有多因素决定论；它包括社会人口统计学、医学和精神病理学参数。这些抑郁症有时难以诊断，尤其是因为没有明确确立的疾病分类标准。通常考虑的一个因素是抑郁症状和/或社会职业功能障碍持续两年以上。一线治疗基于连续两年以上不间断地使用耐受性良好的抗抑郁药，剂量维持在急性期水平。如果治疗失败，目前还没有明确的替代疗法。由于其对社会职业的影响，慢性抑郁症可能成为一个重大的公共卫生问题。迫切需要开展前瞻性长期评估研究。
