Epidemiology of unexplained fatigue and major depression in the community: The Baltimore ECA Follow-up, 1981-1994
Epidemiology of unexplained fatigue and major depression in the community: The Baltimore ECA Follow-up, 1981-1994
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DOI：
10.1017/s0033291701004214
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发表时间：
2001-08-01
影响因子：
6.9
通讯作者：
Eaton, WW
中科院分区：
文献类型：
--
作者：
Addington, AM;Gallo, JJ;Eaton, WW
背景资料。疲劳是一种常见的、非特异性的主观症状，与几种内科和精神疾病有关。本次调查的目的是进一步探讨一般人群中不明原因疲劳的流行病学以及疲劳与抑郁之间的关系。该设计是一项基于人群的前瞻性研究。受试者包括社区居住的成年人，他们是1981年巴尔的摩流行病学集水区计划样本的参与者，并在13年后再次接受采访。业外面试者使用诊断性面试计划采访受试者。结果。在13年的随访间隔中，躯体化症状的数量和烦躁不安的病史是新的疲劳发作以及反复/慢性疲劳的两个最强的预测因素。此外，在基线和随访期间报告有不明原因疲劳史的人，与从未报告这种疲劳史的人相比，新发严重抑郁症的风险显著增加(RR=28.4，95%CI(11.7，68.0))。同样，1981年后出现新的疲劳或缓解疲劳的受访者也有更高的患抑郁症的风险。躯体化是原因不明的新疲劳和慢性疲劳的最强预测因子。此外，疲劳既是抑郁症的预兆，也是抑郁症的后果。
Background. Fatigue is a common, non-specific, subjective symptom associated with several medical and psychiatric illnesses. The purpose of this investigation was to explore further the epidemiology of unexplained fatigue in the general population and the relationship between fatigue and depression.Methods. The design was a prospective population-based study. Subjects included community-dwelling adults who were participants of the Baltimore sample of the Epidemiologic Catchment Area Program in 1981 and who were reinterviewed 13 years later. Lay interviewers using the Diagnostic Interview Schedule interviewed subjects.Results. Number of somatization symptoms and history of a dysphoric episode at baseline were the two strongest predictors of both new onset of fatigue as well as recurrent/chronic fatigue over the 13-year follow-up interval. In addition, individuals who reported a history of unexplained fatigue at baseline as well as during the follow-up, were at markedly increased risk for new onset major depression as compared to those who never reported such fatigue, (RR = 28.4, 95 % CI (11.7, 68.0). Similarly, respondents who developed new fatigue or had remitted fatigue after 1981 were also at increased risk for developing major depression.Conclusions. Somatization was the strongest predictor of both new and chronic fatigue with unknown cause. In addition, fatigue was both predictive and a consequence of the depression syndrome.