The course of depression in adult outpatients. Results from the Medical Outcomes Study.
The course of depression in adult outpatients. Results from the Medical Outcomes Study.
复制标题
成人门诊患者的抑郁症病程。
DOI：
10.1001/archpsyc.1992.01820100032007
复制
发表时间：
1992
影响因子：
--
通讯作者：
Patti Camp
中科院分区：
文献类型：
--
作者：
K. Wells;M. Burnam;W. Rogers;Ron D. Hays;Patti Camp
目的
比较目前患有重性抑郁症、心境恶劣、同时患有抑郁症（“双重抑郁”）或抑郁症状但无抑郁症的成人门诊患者（n = 626）2年期间的抑郁病程。
方法
抑郁症患者访问523临床医生（心理健康专家和一般医疗提供者）确定使用两个阶段的筛选程序，包括诊断面试时间表。抑郁症的过程中进行了评估，在2个后续年的结构化电话采访的基础上的诊断访谈时间表的格式。
结果
双重抑郁患者的基线抑郁症状严重程度最高，但伴有或不伴有重度抑郁的心境恶劣患者的初始功能状态较差。心境恶劣患者的结局最差，那些目前患有重度抑郁症的患者的结局居中，而那些有阈下抑郁症状的患者的结局最好。然而，即使是后一组，在2年内也有很高的重度抑郁发作发生率（25%）。初始抑郁症的严重程度和功能状态水平比抑郁症类型更能解释结果的差异。
结论
研究结果强调，即使在没有重性抑郁症的情况下，与心境恶劣相关的预后不良;阈下抑郁症状的预后意义;以及评估症状严重程度以及功能状态和幸福感的临床意义，无论抑郁症的类型如何。
OBJECTIVE
To compare the course of depression during a 2-year period in adult outpatients (n = 626) with current major depression, dysthymia, and either both current disorders ("double depression") or depressive symptoms with no current depressive disorder.
METHODS
Depressed patients visiting 523 clinicians (mental health specialists and general medical providers) were identified using a two-stage screening procedure including the Diagnostic Interview Schedule. The course of depression was assessed in 2 follow-up years with a structured telephone interview based on the format of the Diagnostic Interview Schedule.
RESULTS
Baseline severity of depressive symptoms was greatest in patients with double depression, but initial functional status was poor in those with dysthymia with or without concurrent major depression. Patients with dysthymia had the worst outcomes, those with current major depression alone had intermediate outcomes, and those with subthreshold depressive symptoms had the best outcomes. Even the latter group, however, had a high incidence (25%) of major depressive episode over 2 years. Initial depression severity and level of functional status accounted for more explained variance in outcomes than did type of depressive disorder.
CONCLUSIONS
The findings emphasize the poor prognosis associated with dysthymia even in the absence of major depression; the prognostic significance of subthreshold depressive symptoms; and the clinical significance of assessing level of severity of symptoms as well as functional status and well-being, regardless of type of depressive disorder.
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DOI：
10.1001/jama.1990.03450190056028
发表时间：
1990-11
期刊：
JAMA
影响因子：
--
作者：
W. Broadhead;D. Blazer;L. George;C. Tse
通讯作者：
W. Broadhead;D. Blazer;L. George;C. Tse
影响因子：
--
作者：
M. Korff;Johan Ormel;Wayne Katon;E. Lin
通讯作者：
M. Korff;Johan Ormel;Wayne Katon;E. Lin
“双重抑郁症”：两年随访。
DOI：
10.1176/ajp.140.6.689
发表时间：
1983
期刊：
The American journal of psychiatry
影响因子：
--
作者：
Keller,MB;Lavori,PW;Endicott,J;Coryell,W;Klerman,GL
通讯作者：
Klerman,GL
精神病学诊断作为具体化的测量。
影响因子：
5
作者：
Mirowsky,J;Ross,CE
通讯作者：
Ross,CE
DOI：
10.1001/jama.1989.03430070062031
发表时间：
1989-08
期刊：
JAMA
影响因子：
--
作者：
K. Wells;A. Stewart;Ron D. Hays;M. Burnam;W. Rogers;M. Daniels;S. Berry;S. Greenfield;J. Ware-J.
通讯作者：
K. Wells;A. Stewart;Ron D. Hays;M. Burnam;W. Rogers;M. Daniels;S. Berry;S. Greenfield;J. Ware-J.