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[阈下抑郁障碍:描述及其在精神病学二级预防中的重要性]

[Subthreshold depressive disorders: description and importance for secondary prevention in psychiatry].

作者信息

Castelnau C, Olie J P, Loo H

机构信息

Service Hospitalo-Universitaire de Santé Mentale et Thérapeutique, Centre Hospitalier Sainte-Anne, Paris.

出版信息

Encephale. 1998 Sep-Oct;24(5):405-14.

PMID:9850814
Abstract

"Subsyndromic" or "subthreshold" mood disorders belong to the category of mood disorders. Because newly studied, few informations are available up to date. The Appendix B of the DSM IV introduces six categories of research criteria which characterize these disorders and give us the thread of our study. From Hippocrate to contemporary specialists, many authors reported mild forms of mood disorders, including the Kraepelin or the psychoanalyst authors views. Dysthymic Disorder, Minor Depressive Disorder and Brief Recurrent Depressive Disorder are different categories of subthreshold unipolar disorders. During their course, these disorders overlap each other and with major mood disorders. Many studies, carried out in primary care practice, pointed out the severe impairment in social functioning, experienced by these patients. We propose a review of "Minor Depressive Disorders", focusing on some points: definitions, epidemiologic studies, "functional impact" of this kind of disorders, comorbidity and therapeutical considerations. Prevalence of suicide is extensive in non major depressive disorders. We discuss interest of "subsyndromic concept" aiming at the prevention of major mood disorders. Moreover, this concept leads to a new clinical approach in the care of mood disorders and provides new fields for psychopathological research.

摘要

“亚综合征性”或“阈下”心境障碍属于心境障碍范畴。由于是新研究的领域,目前可获取的信息较少。《精神疾病诊断与统计手册》第四版附录B介绍了六类研究标准,这些标准对这些障碍进行了描述,并为我们的研究提供了线索。从希波克拉底到当代专家,许多作者都报告过心境障碍的轻度形式,包括克雷佩林或精神分析学派作者的观点。恶劣心境障碍、轻度抑郁障碍和短暂复发性抑郁障碍是阈下单相障碍的不同类别。在病程中,这些障碍相互重叠,也与重度心境障碍重叠。在初级保健实践中进行的许多研究指出,这些患者存在严重的社会功能损害。我们提议对“轻度抑郁障碍”进行综述,重点关注以下几点:定义、流行病学研究、此类障碍的“功能影响”、共病情况以及治疗方面的考虑。自杀在非重度抑郁障碍中很常见。我们讨论“亚综合征概念”在预防重度心境障碍方面的意义。此外,这一概念为心境障碍的护理带来了新的临床方法,并为精神病理学研究提供了新的领域。

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