Duration and severity of depression predict mortality in older adults in the community
Duration and severity of depression predict mortality in older adults in the community
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DOI：
10.1017/s0033291702005585
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发表时间：
2002-05-01
影响因子：
6.9
通讯作者：
Van Tilburg, W
中科院分区：
文献类型：
--
作者：
Geerlings, SW;Beekman, ATF;Van Tilburg, W
背景资料。抑郁症和死亡率之间的联系已经成为一个令人感兴趣的话题。关于抑郁症的病程和死亡率之间的联系，我们知之甚少。在最初没有抑郁的队列(N=325)和抑郁的队列(N=327)中，使用流行病学研究中心抑郁量表(CES-D)在3年内连续8次测量抑郁。随后对两个队列的死亡率状况进行了长达3-5年的跟踪调查。区分临床病程类型和理论病程类型参数(基本症状级别、症状增加和随时间变化的不稳定性)，以研究抑郁症病程对死亡率的影响。与短暂的抑郁状态相反，慢性抑郁和慢性间歇性抑郁都能预测随访时的死亡率。此外，有证据表明，对死亡率的影响与抑郁的严重程度有关；高基本症状水平和随着时间的推移症状的增加预示着死亡率。随着时间的推移高度不稳定与死亡率无关。由于抑郁症的死亡效应是暴露时间和症状严重程度的函数，因此应更加重视抑郁症的治疗，以防止严重的长期抑郁症。
Background. The association between depression and mortality has become a topic of interest. Little is known about the association between the course of depression and mortality.Methods. In an initially non-depressed cohort (N = 325) and a depressed cohort (N = 327), depression was measured using the Center for Epidemiologic Studies Depression scale (CES-D) at eight successive waves over a period of 3 years. Both cohorts were then followed with respect to mortality status for up to 3-5 additional years. Clinical course types as well as theoretical course type parameters (basic symptom levels, increases in symptoms and instability over time) were distinguished to study the effect of the course of depression on mortality.Results. Contrary to transient states of depression, both chronic depression and chronic intermittent depression predicted mortality at follow-up. Additionally, evidence was found that the effect on mortality is related to severity of depression; high basic symptom levels and increases in symptoms over time were predictive of mortality. A high degree of instability over time was not associated with mortality.Conclusions. Since the mortality effect of depression is a function of both exposure time and symptom severity, more attention should be paid to the treatment of depression in order to prevent severe longstanding depression.