Stability and transitions of depressive subtypes over a 2-year follow-up
Stability and transitions of depressive subtypes over a 2-year follow-up
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DOI：
10.1017/s0033291712000141
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发表时间：
2012-10-01
影响因子：
6.9
通讯作者：
Penninx, B. W. J. H.
中科院分区：
文献类型：
--
作者：
Lamers, F.;Rhebergen, D.;Penninx, B. W. J. H.
背景。识别抑郁亚型是减少重度抑郁症异质性的重要工具。然而，很少有研究检验假定的抑郁症亚型随时间的稳定性。方法。样本包括来自荷兰抑郁和焦虑研究 (NESDA) 的 488 名受试者，他们在基线和 2 年随访评估中患有重度抑郁症。应用潜在转变分析（LTA）来检查抑郁亚型在不同时间点的稳定性。在具有稳定亚型的人的子样本中评估了亚型之间人口统计学、临床、心理社会和健康相关性的差异。结果。每个时间点都确定了三种亚型：中度亚型（患病率 T0 39%，T1 42%）、严重典型亚型（T0 30%，T1 25%）和严重非典型亚型（T0 31%，T1 34%）。 LTA 在 2 年随访中显示出 76% 的稳定性，其中严重非典型类别的稳定性最高 (79%)。对稳定亚型的相关性分析显示，在严重非典型亚型中，女性占主导地位，超重和肥胖较多，而在严重典型亚型中，负面生活事件较多，神经质和功能评分较高。结论。研究发现，重度抑郁症的亚型在两年的随访中保持稳定，并且具有不同的决定因素，这支持了所确定的亚型具有临床意义的观点。
Background. Identifying depressive subtypes is an important tool in reducing the heterogeneity of major depressive disorder. However, few studies have examined the stability of putative subtypes of depression over time.Method. The sample included 488 persons from the Netherlands Study of Depression and Anxiety (NESDA) who had major depressive disorder at baseline and at the 2-year follow-up assessment. A latent transition analysis (LTA) was applied to examine the stability of depressive subtypes across time-points. Differences in demographic, clinical, psychosocial and health correlates between subtypes were evaluated in a subsample of persons with stable subtypes.Results. Three subtypes were identified at each time-point: a moderate subtype (prevalence T0 39%, T1 42%), a severe typical subtype (T0 30%, T1 25%), and a severe atypical subtype (T0 31%, T1 34%). The LTA showed 76% stability across the 2-year follow-up, with the greatest stability in the severe atypical class (79%). Analyses of correlates in the stable subtypes showed a predominance of women and more overweight and obesity in the severe atypical subtype, and a greater number of negative life events and higher neuroticism and functioning scores in the severe typical subtype.Conclusions. Subtypes of major depressive disorder were found to be stable across a 2-year follow-up and to have distinct determinants, supporting the notion that the identified subtypes are clinically meaningful.