Sharma V K, Copeland J R, Dewey M E, Lowe D, Davidson I
Department of Psychiatry, University of Liverpool.
Psychol Med. 1998 Nov;28(6):1329-37. doi: 10.1017/s0033291798007521.
Comparatively little is known about the long-term natural history of depressive disorders in the elderly living in the community. This is a follow-up of a subsample of the Continuing Health in the Community study random sample of the elderly population living in Liverpool.
The investigators followed up 120 cases of depression identified by a semi-structured interview schedule (GMS) for a period of 5 years. A similar number of other subjects defined as subcases of depression, other cases of mental illness and a random selection of non-cases were also included.
The 5-year outcome for the cases of depression was worse than the outcome of the non-cases (relative mortality risk of 2.1, 95% confidence interval 1.1 to 3.9). Thirty-four per cent of the cases of depression died and 28% had dropped out during the follow-up. Of the 46 cases of depression who had a complete follow-up, 22% recovered from their symptoms, 30% were found to be AGECAT cases at one of the three follow-up waves, 24% were AGECAT cases at two of the three follow-up waves and the remaining 24% were AGECAT cases at each follow-up wave. Fifteen per cent of the surviving cases of depression were organic cases at the follow-up. Their anxiety comorbid state and depression score were identified as predictors of poor outcome.
The findings of this study indicate that depressive disorders (most of which were untreated) found in the elderly community have a poor prognosis.
对于社区老年人群中抑郁症的长期自然病程，人们了解相对较少。这是对利物浦社区老年人群随机样本中“社区持续健康”研究子样本的一项随访研究。
研究人员对通过半结构化访谈日程表（GMS）确定的120例抑郁症患者进行了为期5年的随访。还纳入了数量相近的其他被定义为抑郁症亚病例、其他精神疾病病例以及随机选取的非病例。
抑郁症患者的5年结局比非病例更差（相对死亡风险为2.1，95%置信区间为1.1至3.9）。34%的抑郁症患者在随访期间死亡，28%失访。在46例完成随访的抑郁症患者中，22%症状缓解，30%在三次随访中的一次被认定为AGECAT病例，24%在三次随访中的两次被认定为AGECAT病例，其余24%在每次随访时均为AGECAT病例。15%存活的抑郁症患者在随访时为器质性病例。他们的焦虑共病状态和抑郁评分被确定为预后不良的预测因素。
本研究结果表明，社区老年人中发现的抑郁症（大多数未接受治疗）预后较差。
