A prospective 12-year study of subsyndromal and syndromal depressive symptoms in unipolar major depressive disorders
A prospective 12-year study of subsyndromal and syndromal depressive symptoms in unipolar major depressive disorders
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DOI：
10.1001/archpsyc.55.8.694
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发表时间：
1998-08-01
影响因子：
--
通讯作者：
Keller, MB
中科院分区：
文献类型：
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作者：
Judd, LL;Akiskal, HS;Keller, MB
背景资料：单相抑郁症（MDD）的研究主要集中在抑郁发作缓解/恢复和复发/复发。方法：将5个中心431例抑郁症患者的每周抑郁症状分为4个严重程度：（1）抑郁症阈值抑郁症状，（2）轻度抑郁或心境恶劣障碍（MinD）阈值抑郁症状，（3）轻度抑郁或心境恶劣障碍（MinD）阈值抑郁症状，（4）轻度抑郁或心境恶劣障碍（MinD）阈值抑郁症状，（5）轻度抑郁或心境恶劣障碍（MinD）阈值抑郁症状。（3）亚综合征或亚阈值抑郁症状（SSD），低于MinD和MDD的阈值;（4）无抑郁症状。在每个级别的周数百分比，症状水平的变化，和药物治疗状态进行了分析的总体和3个亚组定义的情绪障碍history.Results：患者在59%的周内发病。症状水平经常变化（1.8/年），10例患者中有9例在随访期间在3或4个不同的水平上度过了数周。MinD（27%）和SSD（17%）症状水平比MDD（15%）症状水平更常见。双抑郁症和复发性抑郁症患者有更多的慢性症状比患者的第一次生活中的抑郁症发作（72%和65%，分别为IRS 46%的后续wheels）。结论：长期的单极MDD每周的过程中占主导地位的长期症状慢性化。合并MinD和SSD级症状（43%）比MDD级症状（15%）常见约3倍。症状过程是动态和可变的，MDD、MinD和SSD症状水平通常在同一患者中随时间交替，作为单一临床疾病的疾病活动的症状连续体。
Background: Investigations of unipolar major depressive disorder (MDD) have focused primarily on major depressive episode remission/recovery and relapse/ recurrence. This is the first prospective, naturalistic, longterm study of the weekly symptomatic course of MDD.Methods: The weekly depressive symptoms of 431 patients with MDD seeking treatment at 5 academic centers were divided into 4 levels of severity: (1) depressive symptoms at the threshold for MDD; (2) depressive symptoms at the threshold for minor depressive or dysthymic disorder (MinD); (3) subsyndromal or subthreshold depressive symptoms (SSDs),below the thresholds for MinD and MDD; and (4) no depressive symptoms. The percentage of weeks at each level, number of changes in symptom level, and medication status were analyzed overall and for 3 subgroups defined by mood disorder history.Results: Patients were symptomatically ill in 59% of weeks. Symptom levels changed frequently (1.8/y), and 9 of 10 patients spent weeks at 3 or 4 different levers during follow-up. The MinD (27%) and SSD (17%) symptom levels were more common than the MDD (15%) symptom level. Patients with double depression and recurrent depression had more chronic symptoms than patients with their first lifetime major depressive episode (72% and 65%, respectively, irs 46% of follow-up weeks).Conclusion: The long-term weekly course of unipolar MDD is dominated by prolonged symptomatic chronicity. Combined MinD and SSD level symptoms were about 3 times more common (43%) than MDD level symptoms (15%). The symptomatic course is dynamic and changeable, and MDD, MinD, and SSD symptom levels commonly alternate over time in the same patients as a symptomatic continuum of illness activity of a single clinical disease.