A 4-year follow-up study of syndromal and sub-syndromal anxiety and depression symptoms in the general population
A 4-year follow-up study of syndromal and sub-syndromal anxiety and depression symptoms in the general population
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DOI：
10.1007/s00127-007-0289-6
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发表时间：
2008-03-01
影响因子：
4.4
通讯作者：
Linaker, Olav
中科院分区：
文献类型：
--
作者：
Bjerkeset, Ottar;Nordahl, Hans M.;Linaker, Olav
背景我们的目的是在一般人群样本中检测自评焦虑和抑郁症状的稳定性以及4年后病例水平状态变化的预测因素。方法前瞻性队列研究。根据HUNT 2（1995-1997）中医院焦虑和抑郁评定量表（HADS-T）的总评分，确定了三组：3级（n = 654，评分>= 25分），2级（n = 654，评分19-24分）和1级（n = 1，308，评分< 19分）。4年后，这些小组通过邮寄问卷进行了随访。结果在1,326名参与随访的患者中，816名（62%）患者的症状水平没有改变（应答率为53%）。在两个方向上，超过HADS-T病例水平（19分）的参与者人数相同。在基线（1级）的非病例中，缺乏朋友（OR 2.34，95% CI 1.28-4.27，P = 0.006）和既往抑郁发作（OR 2.90，95%CI 1.76-4.78，P < 0.001）预测随访时HADS-T的发生，而文化程度越高（OR 0.66，95% CI 0.46-0.96，P = 0.028），避免了焦虑和抑郁的发展。在HADS-T案件中基线时（2级和3级），既往抑郁发作（OR 0.36，95%CI 0.19-0.68，P = 0.002）和失业（OR 0.58，95%CI 0.34-1.00，P = 0.050）预测随访时HADS-T病例，而较高的教育水平（OR 1.83，95%CI 1.24-2.70，P = 0.002）与4年后HADS-T病例缓解相关。结论虽然症状波动较大，但常规HADS-T评分（≥ 19分）是一般人群中焦虑和抑郁长期症状稳定性较高的一个可靠和有效的预测因子。
Background Our aims were to examine the stability of self-rated anxiety and depression symptoms and the predictors for change in case-level status after 4 years in a general population sample. Methods Prospective cohort study. Based on the total score on the Hospital Anxiety and Depression rating scale (HADS-T) in HUNT 2 (1995-1997), three groups were identified: Level 3 (n = 654, score >= 25 points), Level 2 (n = 654, score 19-24 points), and Level 1 (n = 1,308, score < 19 points). The groups were followed up with a mailed questionnaire after 4 years. Results Among the 1,326 (53% response rate) who participated in the follow-up, 816 (62%) had not changed symptom level. The number of participants that had crossed the HADS-T caseness level (19 points) was the same in both directions. In non-cases at baseline (Level 1), lack of friends (OR 2.34, 95% CI 1.28-4.27, P = 0.006) and previous episodes of depression (OR 2.90, 95% CI 1.76-4.78, P < 0.001) predicted HADS-T caseness at follow-up, while higher educational level (OR 0.66, 95% CI 0.46-0.96, P = 0.028) protected from developing caseness level of anxiety and depression. In HADS-T cases (Levels 2 and 3) at baseline, previous episode(s) of depression (OR 0.36, 95% CI 0.19-0.68, P = 0.002) and being unemployed (OR 0.58, 95% CI 0.34-1.00, P = 0.050) predicted HADS-T caseness at follow-up, whereas a higher educational level (OR 1.83, 95% CI 1.24-2.70, P = 0.002) was associated with remission from HADS-T caseness after 4 years. Conclusions Though symptom fluctuation was considerable, conventional HADS-T caseness (>= 19 points) was a reliable and valid predictor for high long-term symptom stability of anxiety and depression in our general population sample.