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双重抑郁:单相抑郁的一种独特亚型。

Double depression: a distinctive subtype of unipolar depression.

作者信息

Keller M B, Hirschfeld R M, Hanks D

机构信息

Brown University, Department of Psychiatry and Human Behavior, Providence, RI 02912, USA.

出版信息

J Affect Disord. 1997 Aug;45(1-2):65-73. doi: 10.1016/s0165-0327(97)00060-8.

Abstract

Whether depression is a single disease that varies from mild to severe, with varying episode durations and difficult course patterns, or whether it is an umbrella diagnosis representing depressive subtypes with different psychological and biological characteristics has been debated by clinicians and researchers for many years. However, most scientists now agree that understanding the heterogeneous subtypes of depression allows for greater accuracy in describing and differentiating patients suffering from depression and, therefore, greater precision in describing the most efficacious treatment plan. This article will focus on the distinctions between unipolar major depression, double depression and dysthymia, and will review the history of the DSM classifications for these "subtypes" of major depressive disorder, clinicians and researchers continue to subclassify major depression and, particularly, for the purpose of testing the efficacy of new psychopharmocologic and psychosocial treatments. There continues to be a need for future research to more clearly establish the predictive value in terms of course, recovery, rates of relapse and treatment in regard to distinguishing type of depression as well as to validate the current nosology.

摘要

抑郁症究竟是一种从轻度到重度、发作持续时间各异且病程模式复杂的单一疾病,还是一种涵盖具有不同心理和生物学特征的抑郁亚型的笼统诊断,临床医生和研究人员已争论多年。然而,现在大多数科学家都认为,了解抑郁症的异质亚型有助于更准确地描述和区分抑郁症患者,从而在制定最有效的治疗方案时更具精准性。本文将重点关注单相重度抑郁症、双重抑郁症和恶劣心境之间的区别,并回顾《精神疾病诊断与统计手册》(DSM)对这些重度抑郁症“亚型”的分类历史,临床医生和研究人员继续对重度抑郁症进行细分,特别是为了测试新的心理药物和心理社会治疗的疗效。未来的研究仍有必要更明确地确定区分抑郁症类型在病程、康复、复发率和治疗方面的预测价值,并验证当前的疾病分类学。

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