Klein D N, Norden K A, Ferro T, Leader J B, Kasch K L, Klein L M, Schwartz J E, Aronson T A
Department of Psychology, State University of New York, Stony Brook 11794-2500, USA.
J Abnorm Psychol. 1998 May;107(2):338-48. doi: 10.1037//0021-843x.107.2.338.
Dysthymic disorder (DD) is defined and distinguished from major depressive disorder (MDD) largely on the basis of its course. Surprisingly, however, there have been few prospective, longitudinal studies of the naturalistic course of DD. This article reports the major findings from a prospective, longitudinal 30-month follow-up study of 86 outpatients with early-onset DD (EOD) and 39 outpatients with episodic MDD. Follow-up assessments included the Longitudinal Interval Follow-Up Evaluation and Hamilton Rating Scale for Depression. Compared with patients with episodic MDD, patients with EOD exhibited less improvement from the baseline evaluation and were more symptomatic at follow-up. Only 39% of patients with EOD recovered from DD during the follow-up period. The diagnosis of DD was fairly stable, with 52% of the EOD group meeting full criteria for DD at follow-up. These data provide prospective confirmation of the chronic course of DD.
恶劣心境障碍（DD）主要依据其病程与重度抑郁症（MDD）进行定义和区分。然而，令人惊讶的是，针对DD自然病程的前瞻性纵向研究却很少。本文报告了一项针对86例早发性DD（EOD）门诊患者和39例发作性MDD门诊患者进行的为期30个月的前瞻性纵向随访研究的主要结果。随访评估包括纵向间隔随访评估和汉密尔顿抑郁量表。与发作性MDD患者相比，EOD患者从基线评估开始改善较少，且在随访时症状更明显。在随访期间，只有39%的EOD患者从DD中康复。DD的诊断相当稳定，EOD组中有52%的患者在随访时符合DD的全部标准。这些数据为DD的慢性病程提供了前瞻性证实。
