Characteristics, comorbidities, and correlates of atypical depression: evidence from the UK Biobank Mental Health Survey
Characteristics, comorbidities, and correlates of atypical depression: evidence from the UK Biobank Mental Health Survey
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DOI：
10.1017/s0033291719001004
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发表时间：
2020-05-01
影响因子：
6.9
通讯作者：
Hotopf, Matthew
中科院分区：
文献类型：
--
作者：
Brailean, Anamaria;Curtis, Jessica;Hotopf, Matthew
背景抑郁症是一种多病因、多治疗靶点的异质性疾病。本研究旨在确定以逆转的植物神经症状为特征的非典型抑郁症（AD）是否与非典型抑郁症（nonAD）相比具有更有害的病程以及不同的社会人口学、生活方式和合并症特征。方法在157 366名完成英国生物银行心理健康问卷（MHQ）的成年人中，N = 37 434（24%）符合DSM-5基于复合国际诊断访谈简表的可能终生重度抑郁障碍（MDD）标准。报告嗜睡和体重增加的参与者被归类为AD病例（N = 2305），其他被归类为非AD病例（N = 35129）。进行Logistic回归分析，以检查AD和非AD之间的抑郁症特征，社会人口和生活方式因素，生活逆境，精神和身体共病的差异。结果AD患者抑郁症发病年龄早于非AD患者，抑郁症发作时间长、程度重、反复发作次数多，求助率高。AD与女性性别、不健康行为（吸烟、社交孤立、低体力活动）、更多的终身剥夺和逆境、更高的共病精神疾病、肥胖、心血管疾病（CVD）和代谢综合征的发生率相关。比较AD患者与具有典型神经植物性症状（睡眠不足和体重减轻）的患者的敏感性分析显示了相似的结果。结论这些发现突出了AD作为一种慢性抑郁症的临床和公共卫生意义，与高并发症和终身逆境相关。我们的研究结果对预测抑郁症病程和合并症、指导病因机制研究、规划服务使用和告知治疗方法具有重要意义。
Background Depression is a heterogeneous disorder with multiple aetiological pathways and multiple therapeutic targets. This study aims to determine whether atypical depression (AD) characterized by reversed neurovegetative symptoms is associated with a more pernicious course and a different sociodemographic, lifestyle, and comorbidity profile than nonatypical depression (nonAD). Methods Among 157 366 adults who completed the UK Biobank Mental Health Questionnaire (MHQ), N = 37 434 (24%) met the DSM-5 criteria for probable lifetime major depressive disorder (MDD) based on the Composite International Diagnostic Interview Short Form. Participants reporting both hypersomnia and weight gain were classified as AD cases (N = 2305), and the others as nonAD cases (N = 35 129). Logistic regression analyses were conducted to examine differences between AD and nonAD in depression features, sociodemographic and lifestyle factors, lifetime adversities, psychiatric and physical comorbidities. Results Persons with AD experienced an earlier age of depression onset, longer, more severe and recurrent episodes, and higher help-seeking rates than nonAD persons. AD was associated with female gender, unhealthy behaviours (smoking, social isolation, low physical activity), more lifetime deprivation and adversity, higher rates of comorbid psychiatric disorders, obesity, cardiovascular disease (CVD), and metabolic syndrome. Sensitivity analyses comparing AD persons with those having typical neurovegetative symptoms (hyposomnia and weight loss) revealed similar results. Conclusions These findings highlight the clinical and public health significance of AD as a chronic form of depression, associated with high comorbidity and lifetime adversity. Our findings have implications for predicting depression course and comorbidities, guiding research on aetiological mechanisms, planning service use and informing therapeutic approaches.