Depressive symptoms as relative and attributable risk factors for first-onset major depression.
Depressive symptoms as relative and attributable risk factors for first-onset major depression.
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DOI：
10.1001/archpsyc.1992.01820100061011
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发表时间：
1992-10
影响因子：
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通讯作者：
E. Horwath;James A. Johnson;G. Klerman;Myrna M. Weissman
中科院分区：
文献类型：
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作者：
E. Horwath;James A. Johnson;G. Klerman;Myrna M. Weissman
使用纵向数据，从9900名成年人的社区研究，从四个网站在美国和采访了两次，1年的间隔，我们调查了首发抑郁症的预测。使用比值比来估计相对风险，我们发现，与没有这些症状的人相比，有抑郁症状的人在1年内发展为首发抑郁症的可能性高4.4倍，而心境恶劣的人则高5.5倍。抑郁症状的终生患病率为24%。归因风险是一种复合流行病学指标，反映了与抑郁症状相关的相对风险（4.4）和暴露于该风险的患病率（24%）。这是记录社区风险负担的一个有用措施，它被确定为大于50%。因此，超过50%的首发重性抑郁症病例与先前的抑郁症状有关。抑郁症状在社区中的高患病率及其与首次发作的重性抑郁症的密切联系使其从公共卫生的角度来看非常重要。由于抑郁症状在临床实践中往往未被识别和治疗，我们的结论是，他们的识别和有效治疗的发展可能会对预防重性抑郁症产生影响。
Using longitudinal data from a community study of 9900 adults drawn from four sites in the United States and interviewed twice, 1 year apart, we investigated the predictors of first-onset major depression. Using odds ratios to estimate relative risk, we found that persons with depressive symptoms, compared with those without such symptoms, were 4.4 times more likely and persons with dysthymia were 5.5 times more likely to develop a first-onset major depression during a 1-year period. The lifetime prevalence rate for depressive symptoms was 24%. The attributable risk is a compound epidemiologic measure that reflects both the relative risk associated with depressive symptoms (4.4) and the prevalence of exposure to that risk (24%). It is a useful measure to document the burden of a risk to the community, and it was determined to be greater than 50%. Thus, more than 50% of cases of first-onset major depression are associated with prior depressive symptoms. The high prevalence of depressive symptoms in the community and their strong association with first-onset major depression make them important from a public health perspective. Because depressive symptoms are often unrecognized and untreated in clinical practice, we conclude that their identification and the development of effective treatments could have implications for the prevention of major depression.