Kessler R C, Walters E E
Department of Health Care Policy, Harvard Medical School, Boston, MA 02115-5899, USA.
Depress Anxiety. 1998;7(1):3-14. doi: 10.1002/(sici)1520-6394(1998)7:1<3::aid-da2>3.0.co;2-f.
Data on the prevalences, comorbidities, and cohort effects of DSM-III-R major depression (MD) and minor depression (mD) are reported for the nationally representative sample of n = 1,769 adolescents and young adults who participated in the National Comorbidity Survey. Lifetime prevalences are 15.3% (MD) and 9.9% (mD), while 30-day prevalences are 5.8% (MD) and 2.1% (mD). Most cases reported recurrent episodes (73.9% of those with MD and 69.2% with mD) and significant role impairment, including attempted suicide among 21.9% of those with MD. The majority of lifetime cases (76.7% of those with MD and 69.3% with mD) reported other comorbid lifetime NCS/ DSM-III-R disorders. Depression was temporally secondary in the majority of these cases. Number of prior disorders was more important than type of disorders in predicting subsequent depression, raising the possibility that secondary depression is a nonspecific severity marker for earlier disorders. A cohort effect for both MD and mD was documented that persisted even for episodes lasting a year or longer. Increasing prevalences of prior comorbid disorders were found to play an important part in explaining the cohort effect for depression.
针对参与全国共病调查的1769名具有全国代表性的青少年和青年成年人样本,报告了DSM-III-R重度抑郁症(MD)和轻度抑郁症(mD)的患病率、共病情况及队列效应。终生患病率分别为15.3%(MD)和9.9%(mD),而30天患病率分别为5.8%(MD)和2.1%(mD)。大多数病例报告有复发发作(MD患者中73.9%,mD患者中69.2%)以及显著的角色功能损害,包括MD患者中有21.9%曾尝试自杀。大多数终生病例(MD患者中76.7%,mD患者中69.3%)报告有其他共病的终生NCS/DSM-III-R障碍。在大多数这些病例中,抑郁症在时间上是继发性的。在预测后续抑郁症方面,既往障碍的数量比障碍类型更重要,这增加了继发性抑郁症是早期障碍的非特异性严重程度标志物的可能性。记录了MD和mD的队列效应,即使对于持续一年或更长时间的发作也持续存在。发现既往共病障碍患病率的增加在解释抑郁症的队列效应中起重要作用。