Judd L L, Paulus M P, Wells K B, Rapaport M H
Department of Psychiatry, University of California, San Diego 92093-0603, USA.
Am J Psychiatry. 1996 Nov;153(11):1411-7. doi: 10.1176/ajp.153.11.1411.
The authors' goal was to evaluate the association between impairment in daily function and subsyndromal depressive symptoms as well as major depression to determine the economic and societal significance of these conditions.
Using 12-month prevalence data gathered by the National Institute of Mental Health (NIMH) Epidemiologic Catchment Area Program (ECA), based on responses to the NIMH Diagnostic Interview Schedule, the authors divided the 2,393 subjects from the Los Angeles ECA site into three groups: subjects with subsyndromal depressive symptoms (N = 270), major depression (N = 102), and no depressive disorder or symptoms (N = 2,021). The groups were compared on 10 domains of functional outcome and well-being.
Significantly more subjects with depressive symptoms than subjects who had no disorder reported high levels of household strain, social irritability, and financial strain as well as limitations in physical or job functioning, restricted activity days, bed days, and poor health status. Significantly more subjects with major depression than subjects with no disorder reported major financial losses, bed days, high levels of financial strain, limitations in physical or job functioning, and poor health status. Except for lower self-ratings of health status, no significant differences were found between subjects with subsyndromal symptoms and those with major depression.
Significantly more people with subsyndromal depressive symptoms or major depression reported impairment in eight of 10 functional domains than did subjects with no disorder. The high 1-year prevalence of subsyndromal depressive symptoms, combined with the associated functional impairment, emphasizes the clinical and public health importance and need for additional investigations into these symptoms.
作者的目标是评估日常功能损害与亚综合征抑郁症状以及重度抑郁之间的关联，以确定这些状况的经济和社会意义。
利用美国国立精神卫生研究所（NIMH）流行病学集水区项目（ECA）收集的12个月患病率数据，基于对NIMH诊断访谈表的回答，作者将来自洛杉矶ECA站点的2393名受试者分为三组：有亚综合征抑郁症状的受试者（N = 270）、重度抑郁患者（N = 102）以及无抑郁障碍或症状的受试者（N = 2021）。对这三组在功能结局和幸福感的10个领域进行比较。
与无疾病的受试者相比，有抑郁症状的受试者报告家庭压力、社交易怒和经济压力水平较高以及身体或工作功能受限、活动受限天数、卧床天数和健康状况较差的比例显著更高。与无疾病的受试者相比，重度抑郁患者报告重大经济损失、卧床天数、经济压力水平较高、身体或工作功能受限以及健康状况较差的比例显著更高。除了健康状况的自我评分较低外，亚综合征症状患者与重度抑郁患者之间未发现显著差异。
与无疾病的受试者相比，有亚综合征抑郁症状或重度抑郁的受试者在10个功能领域中的8个领域报告有损害的比例显著更高。亚综合征抑郁症状的高1年患病率，加上相关的功能损害，强调了这些症状在临床和公共卫生方面的重要性以及对其进行进一步研究的必要性。
