Clinical and demographic factors associated with DSM-IV melancholic depression.
Clinical and demographic factors associated with DSM-IV melancholic depression.
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DOI：
10.1080/10401230600614496
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发表时间：
2006-04-01
期刊：
影响因子：
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通讯作者：
Fava, Maurizio
中科院分区：
文献类型：
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作者：
Khan, Ahsan Y;Carrithers, Joe;Fava, Maurizio
背景：本文的目的是利用大量被诊断为非精神病性重性抑郁症的门诊患者的人口统计和临床数据来调查 DSM-IV 中忧郁性抑郁症概念的有效性。 方法：收集了 1500 名参与缓解抑郁的序贯治疗替代方案的非精神病性重性抑郁症 (MDD) 门诊患者（其中 1456 例可以确定为忧郁症）的基线临床和人口统计数据（STAR*D）研究。使用 17 项汉密尔顿抑郁评定量表 (HRS-D17) 和 30 项抑郁症状量表 (IDS-C30) 通过临床电话访谈评估抑郁症状严重程度。通过记录研究参与者认可的与每个诊断类别相关的项目数量，使用自我报告、精神病诊断筛查问卷 (PDSQ) 来测量并发精神症状的类型和程度。 结果：根据抑郁症严重程度（通过 HRS-D17 总分衡量）进行调整后，发现种族、婚姻状况、教育程度、就业状况、抑郁症家族史、初级保健与专科保健、每月的抑郁症发病率没有差异。收入以及精神和医学共病的程度。男性患忧郁症的可能性明显高于女性。调整严重程度后的忧郁抑郁症与进入研究时的年龄稍小、疾病严重程度较高以及当前发作的持续时间稍短有关。西班牙裔种族与较低的忧郁性抑郁发生率相关，显着性水平为 0.06。结论：在 MDD 门诊患者中，西班牙裔患者出现忧郁特征的可能性较小，但较年轻的患者和男性出现忧郁特征的可能性更大。忧郁的特征也与当前发作时间稍短有关。这些发现与外部社会人口因素在忧郁性抑郁症的病理生理学中不起重要作用的观点是一致的。
BACKGROUND: The purpose of this paper is to use demographic and clinical data from a large diverse group of outpatients diagnosed with non-psychotic major depression to investigate the validity of the DSM-IV concept of melancholic depression.METHODS: Baseline clinical and demographic data were collected on 1500 outpatients (1456 of whom melancholia could be determined) with non-psychotic major depressive disorder (MDD) participating in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study. Depressive symptom severity was assessed by clinical telephone interview using the 17-item Hamilton Rating Scale for Depression (HRS-D17) and the 30-item Inventory of Depressive Symptomatology (IDS-C30). The types and degrees of concurrent psychiatric symptoms were measured using a self report, the Psychiatric Diagnostic Screening Questionnaire (PDSQ), by recording the number of items relevant to each diagnostic category endorsed by study participants.RESULTS: Adjusting for severity of depression (as measured by the total HRS-D17 scores), no differences were found in the rate of melancholic depression by race, marital status, education, employment status, family history of depression, primary care versus specialty care, monthly income, and degree of psychiatric and medical co-morbidity. Melancholic depression was significantly more likely in men than women. Melancholic depression after adjustment for severity was associated with a slightly younger age at study entry, as well as with greater illness severity, and slightly shorter duration of current episode. Hispanic ethnicity was associated with lower melancholic depression rates at the .06 level of significance.CONCLUSIONS: Among outpatients with MDD, melancholic features were less likely in Hispanic patients, but more likely in slightly younger patients and in men. Melancholic features were also related to a slightly shorter current episode. These findings are consistent with the notion that external socio-demographic factors do not play an important role in the pathophysiology of melancholic depression.