Young adult cognitive ability and subsequent major depression in a cohort of 666,804 Danish men
Young adult cognitive ability and subsequent major depression in a cohort of 666,804 Danish men
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DOI：
10.1016/j.jad.2018.04.035
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发表时间：
2018-08-01
影响因子：
6.6
通讯作者：
Osler, Merete
中科院分区：
文献类型：
--
作者：
Christensen, Gunhild Tidemann;Rozing, Maarten Pieter;Osler, Merete
背景：早期生活认知能力(CA)可能影响患重度抑郁症(MD)的风险。目的：研究青年CA和随后的MD与不同的MD疾病特征之间的关系。方法：通过1957-1984年征兵委员会检查(平均年龄19岁)评估关于CA的信息，关于MD的信息基于从1969年至2015年丹麦患者登记中检索的医院诊断。结果：在平均40.8年的随访期中，共有666,804名男性(出生于1939-1959年)接受了跟踪调查，其中25,841人(3.9%)发展为MD。CA越低，发生MD的风险越高。早发(=60岁)MD的相关性更强(HRper1SD下降=1.14；95%CI：1.11、1.16)，但CA与抑郁发作次数无关。与复发性抑郁症(HRper1SD下降=1.13；95%CI：1.09，1.16)相比，单次抑郁发作(HRper1SD下降=1.21；95%CI：1.19，1.23)的相关性更强，而相关性的强度并不因MD疾病的严重程度而异(ICD10：轻度、中度和重度抑郁)。局限性：研究样本仅包括男性，仅包括在医院确诊的MD病例，这限制了推广。结论：低CA可能是男性尤其是早发性MD的危险因素，而CA对复发的影响似乎不那么强烈。较低的发病前CA增加了MD的风险，因此在临床实践中应作为抑郁症风险评估的一部分。
Background: Early life cognitive ability (CA) might influence the risk of developing major depression (MD). The aim was to investigate the association between young adult CA and subsequent MD in relation to different MD disease characteristics.Methods: Information on CA was assessed at conscription board examinations 1957-1984 (mean age 19 years) and information on MD was based on hospital diagnosis retrieved from Danish Patient registers 1969-2015. Associations between CA and MD were examined using Cox regression analyses.Results: A total of 666,804 men (born 1939-1959) were followed and 25,841 (3.9%) developed MD during a mean follow-up of 40.8 years. Lower CA was associated with an increased risk of incident MD. The association was stronger for early-onset (= 60 years) MD (HRper1SDdecrease = 1.14; 95%CI:1.11,1.16), but CA was not related to number of depressive episodes. The association was stronger for single depressive episodes (HRper1SDdecrease = 1.21; 95%CI:1.19,1.23) compared to recurrent depression (HRper1SDdecrease = 1.13; 95%CI:1.09,1.16), while the strength of the association did not differ according to MD disease severity (ICD10: mild, moderate, and severe depression). Limitations: The study sample only included men and only MD cases diagnosed at hospital were included which limits the generalizability.Conclusion: Low CA could be a risk factor for especially early onset MD in men, whereas the influence of CA on re-occurrence seems less strong. Lower pre-morbid CA increases the risk of MD and should therefore be part of the depression risk assessment in clinical practice.