Dimensionality and the category of major depressive episode
Dimensionality and the category of major depressive episode
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DOI：
10.1002/mpr.216
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发表时间：
2007-06-01
影响因子：
3.1
通讯作者：
Slade, Timothy
中科院分区：
文献类型：
--
作者：
Andrews, Gavin;Brugha, Traoloach;Slade, Timothy
重性抑郁发作（MDE）是一种以发作缓解和复发为特征的慢性疾病。它是造成疾病负担的主要因素。疾病的诊断是专家认为疾病存在。MDE的九种症状存在于强度或大或小、随时间持续、通常状态改变、痛苦和损害的维度上。临床医生的任务是判断所引起的症状是否需要诊断。令人惊讶的是，训练有素的临床医生可以可靠地做到这一点，诊断访谈和问卷调查可以模拟这一过程，社区调查中的症状分布是指数级的，在诊断阈值上没有明显的间断。税收和初级保健研究证实了这一点。症状的数量预测严重程度，合并症，家族史，残疾，寻求帮助和治疗建议。精神障碍的潜在结构将MDE置于痛苦痛苦集群中，幸福感、痛苦、残疾和神经质与症状数量相关，但关系并不完美。患者健康调查问卷源自诊断标准，不受此限制。引入这样的措施将承认维度，将促进承认，指导治疗，并为消费者，供应商和资助者所接受。版权所有（c）2007约翰威利父子有限公司。
Major depressive episode (MDE) is a chronic disease typified by episodes that remit and recur. It is a major contributor to the burden of disease. The diagnosis of a disorder is an expert opinion that the disorder is present. The nine symptoms of MDE exist on dimensions of greater or lesser intensity, persistence over time, change in usual state, distress and impairment. It is the clinician's task to judge whether the elicited symptoms warrant the diagnosis. The surprise is that trained clinicians can do this reliably and that diagnostic interviews and questionnaires can emulate this process.The distribution of symptoms in community surveys is exponential, with no obvious discontinuity at the diagnostic threshold. Taxometric and primary care studies confirm this. The number of symptoms predicts severity, comorbidity, family history, disability, help seeking and treatment recommendations. The latent structure of mental disorders places MDE in the distress misery cluster.Measures of well-being, distress, disability and neuroticism correlate with the number of symptoms but the relation is not perfect. The Patient Health Questionnaire is derived from the diagnostic criteria and does not suffer this limitation. The introduction of measures like this would acknowledge dimensionality, would facilitate recognition, guide treatment, and be acceptable to consumers, providers and funders. Copyright (c) 2007 John Wiley & Sons, Ltd.