Psychosocial disability during the long-term course of unipolar major depressive disorder
Psychosocial disability during the long-term course of unipolar major depressive disorder
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DOI：
10.1001/archpsyc.57.4.375
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发表时间：
2000-04-01
影响因子：
--
通讯作者：
Keller, MB
中科院分区：
文献类型：
--
作者：
Judd, LL;Akiskal, HS;Keller, MB
背景资料：本研究的目的是探讨心理社会残疾与抑郁症状严重程度的长期过程中的单相抑郁症（MDD）。方法：每月评级的损害主要生活功能和社会关系，平均10年的系统随访期间获得的371例单相抑郁症在美国国家精神卫生研究所的抑郁症协作研究。随机回归模型被用来检查与3个水平的抑郁症状的严重程度和无症状的status.Results：一个渐进的梯度的心理社会功能的变化与抑郁症状的严重程度，范围从无症状到阈下抑郁症状的轻度抑郁症/心境恶劣水平的症状在MDD水平的症状的水平的平行梯度。残疾的显着增加发生在抑郁症状严重程度的每一个逐步增加。结论：在长期的过程中，残疾是普遍的和慢性的，但消失时，患者成为无症状。阈下抑郁症状、轻度抑郁/心境恶劣和MDD水平的抑郁症状代表了单极MDD中抑郁症状严重程度的连续性，每个水平均与心理社会残疾的显著逐步增加相关。
Background: The goal of this study was to investigate psychosocial disability in relation to depressive symptom severity during the long-term course of unipolar major depressive disorder (MDD).Methods: Monthly ratings of impairment in major life functions and social relationships were obtained during an average of 10 years' systematic follow-up of 371 patients with unipolar MDD in the National Institute of Mental Health Collaborative Depression Study. Random regression models were used to examine variations in psychosocial functioning associated with 3 levels of depressive symptom severity and the asymptomatic status.Results: A progressive gradient of psychosocial impairment was associated with a parallel gradient in the level of depressive symptom severity which ranges from asymptomatic to subthreshold depressive symptoms to symptoms at the minor depression/dysthymia level to symptoms at the MDD level. Significant increases in disability occurred with each stepwise increment in depressive symptom severity. Conclusions: During the long-term course, disability is pervasive and chronic but disappears when patients become asymptomatic. Depressive symptoms at levels of subthreshold depressive symptoms, minor depression/dysthymia, and MDD represent a continuum of depressive symptom severity in unipolar MDD, each level of which is associated with a significant stepwise increment in psychosocial disability.