A daily diary study of late-life depression
A daily diary study of late-life depression
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DOI：
10.1097/01.jgp.0000194644.63245.42
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发表时间：
2006-03-01
影响因子：
7.2
通讯作者：
Katz, IR
中科院分区：
文献类型：
--
作者：
Chepenik, LG;Ten Have, T;Katz, IR
目的：本研究的目的是利用日常日记的数据来表征老年抑郁症初级保健患者的积极和消极影响的日常变异性，以及日常事件与日常影响之间的关系。方法：选取重度抑郁症（N = 25）和其他抑郁症（N = 33）的初级保健患者的日常日记资料；将为期两周的数据与参加其他研究的老年正常志愿者比较对象（N = 70）的数据进行比较。结果：重度抑郁症和其他抑郁症患者的负性情绪存在显著的日常变异性。焦虑天数（正常受试者每两周出现一次负面情绪评分的天数）在重度抑郁症患者中占65.3%（标准差[SD]: 37.1），在其他抑郁症患者中占50.6% (SD: 37.6)，而在正常受试者中占7.7% (SD: 16.3) （F = 36.0, p < 0.001）。两组在报告的积极和消极事件的数量上没有显著差异，但与消极事件相关的焦虑天数的比例在正常受试者中比在重度抑郁症患者中要大。混合效应分析表明，重度抑郁症患者对积极事件的积极情感反应减弱，这与享乐过程的损伤是一致的，而患有其他抑郁症的患者对消极事件的消极情感反应增强，高于正常受试者和重度抑郁症患者。结论：日记法显示了晚期抑郁症的特征，而这些特征没有被具有较低时间分辨率的评估方法所识别。
Objective: The objective of this study was to use data from daily diaries to characterize the day-to-day variability in positive and negative affects, and the relationship between daily events and daily affects in primary care patients with late-life depression. Method: Daily diary data were obtained from primary care patients with major depression (N = 25) and other depressive disorders (N = 33); data from a two-week period were compared with those from elderly normal volunteer comparison subjects (N = 70) who participated in other studies. Results: There was significant day-to-day variability in negative affect in patients with major depression and other depressive disorders. Dysphoric days ( days with a negative affect ratings that occurred once every two weeks in normal subjects) represented 65.3% ( standard deviation [SD]: 37.1) of days in those with major depression and 50.6% (SD: 37.6) in those with other depression versus 7.7% (SD: 16.3) in normal subjects (F = 36.0, p < 0.001). The groups did not differ significantly in the number of positive and negative events reported, but the proportion of dysphoric days that occurred in association with negative events was greater in normal subjects than in those with major depression. Mixed-effects analyses demonstrated that patients with major depression had blunted positive affective responses to positive events, consistent with impairments in hedonic processes, and that patients with other depressions exhibited heightened negative affective responses to negative events, greater than those in normal subjects and patients with major depression. Conclusions: Diary methods demonstrated characteristics of late-life depression that have not been identified with assessment methods that have lower time resolution.