Klein D N, Lewinsohn P M, Seeley J R
State University of New York at Stony Brook 11794-2500, USA.
J Affect Disord. 1997 Feb;42(2-3):127-35. doi: 10.1016/s0165-0327(96)01403-6.
Little is known about the psychosocial functioning of persons who have recovered from dysthymic disorder. Such information might be useful in identifying trait markers for dysthymia, and for guiding continuation and maintenance treatment. We explored this issue using data from the Oregon Adolescent Depression Project, a large community-based study of the epidemiology of psychiatric disorders in a high school population. Four groups of adolescents were identified: 38 with a past history of dysthymic disorder; 217 with a past history of major depressive disorder; 142 with a past history of non-affective disorders; and 1079 with no lifetime history of psychopathology. The groups were compared on an extensive battery of psychosocial variables. The most consistent and diagnostically specific finding was that adolescents with a past history of dysthymic disorder reported having a significantly lower level of social support from friends than each of the other three groups of adolescents. Adolescents with a past history of dysthymic disorder also reported significantly higher levels of depressive, internalizing and externalizing symptoms and daily hassles than adolescents with no lifetime history of psychopathology. In addition, they reported higher levels of depressive symptoms and self-consciousness, but fewer externalizing symptoms than adolescents with a past history of non-affective disorders. These data suggest that adolescents with dysthymic disorder continue to experience significant difficulties in psychosocial functioning even after recovery.
关于心境恶劣障碍康复者的心理社会功能,人们了解甚少。此类信息可能有助于识别心境恶劣障碍的特质标记,并指导延续性和维持性治疗。我们利用俄勒冈青少年抑郁项目的数据对这一问题进行了探究,该项目是一项针对高中人群精神疾病流行病学的大型社区研究。我们确定了四组青少年:38名有心境恶劣障碍病史;217名有重度抑郁症病史;142名有非情感性障碍病史;以及1079名无精神病理学终生史。我们在一系列广泛的心理社会变量上对这些组进行了比较。最一致且具有诊断特异性的发现是,有心境恶劣障碍病史的青少年报告称,他们从朋友那里获得的社会支持水平明显低于其他三组青少年。有心境恶劣障碍病史的青少年还报告称,他们的抑郁、内化和外化症状以及日常烦恼的水平明显高于无精神病理学终生史的青少年。此外,与有非情感性障碍病史的青少年相比,他们报告的抑郁症状和自我意识水平更高,但外化症状更少。这些数据表明,患有心境恶劣障碍的青少年即使在康复后,在心理社会功能方面仍继续经历重大困难。