Association of different adverse life events with distinct patterns of depressive symptoms
Association of different adverse life events with distinct patterns of depressive symptoms
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DOI：
10.1176/appi.ajp.2007.06091564
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发表时间：
2007-10-01
影响因子：
17.7
通讯作者：
Kendler, Kenneth S.
中科院分区：
文献类型：
--
作者：
Keller, Matthew C.;Neale, Michael C.;Kendler, Kenneth S.
目的：作者试图确定是否，在一般人群样本中，不同类别的不良生活事件与不同模式的抑郁症状。方法：共有4,856人（53%女性）谁经历了抑郁症状，在过去的一年中进行了评估，最多四波超过12年。在每一波，参与者报告的严重程度，12个症状分解从9个DSM-III-R标准的严重抑郁症和自我确定的原因，这些症状，分为9类不良生活事件。结果：模式的抑郁症状与9类不良生活事件显着不同。亲人的死亡和浪漫的分手都以高水平的悲伤、快感缺失、食欲不振和（对于浪漫的分手）内疚为标志。慢性压力和较小程度的失败与疲劳和嗜睡有关，但与悲伤、快感缺乏和食欲不振有关。那些报告说没有不良生活事件导致他们的烦躁发作的人报告说疲劳，食欲增加和自我伤害的想法，但较少悲伤或注意力不集中。这些症状模式是在对有单一烦躁发作的参与者进行的人与人之间的分析中发现的，并且在对有多个发作的个体之间的发作特异性症状偏差进行的独立人与人之间的分析中复制。当样本仅限于那些符合DSM-III-R诊断标准的抑郁症。结论：抑郁症是一种病理综合征。不同类型的生活事件与不同的抑郁症状谱相关。内部人员分析的结果表明，这些关系是因果关系。
Objective: The authors sought to determine whether, in a general population sample, different categories of adverse life events were associated with different patterns of depressive symptoms.Method: A total of 4,856 individuals (53% female) who experienced depressive symptoms in the previous year were assessed in up to four waves over a maximum of 12 years. At each wave, participants reported the severity of 12 symptoms disaggregated from the nine DSM-III-R criteria for major depression and the self-identified cause of these symptoms, which were classified into nine categories of adverse life events.Results: The patterns of depressive symptoms associated with the nine categories of adverse life events differed significantly. Deaths of loved ones and romantic breakups were marked by high levels of sadness, anhedonia, appetite loss, and (for romantic breakups) guilt. Chronic stress and, to a lesser degree, failures were associated with fatigue and hypersomnia, but less so with sadness, anhedonia, and appetite loss. Those who reported that no adverse life events caused their dysphoric episodes reported fatigue, appetite gain, and thoughts of self-harm, but less sadness or trouble concentrating. These symptom patterns were found in a between-persons analysis of participants who had a single dysphoric episode, and they were replicated in an independent within-persons analysis of episode-specific symptom deviations among individuals with multiple episodes. Similar results were obtained when the sample was restricted to those meeting DSM-III-R diagnostic criteria for major depression.Conclusions: Depression is a pathoplastic syndrome. Different types of life events are related to different depressive symptom profiles. The results from the within persons analysis suggest that these relationships are causal.