Sex differences in clinical predictors of depression: a prospective study.
Sex differences in clinical predictors of depression: a prospective study.
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DOI：
10.1016/j.jad.2013.05.010
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发表时间：
2013-09-25
影响因子：
6.6
通讯作者：
Galfalvy, Hanga
中科院分区：
文献类型：
--
作者：
Oquendo, Maria A.;Turret, Jason;Grunebaum, Michael F.;Burke, Ainsley K.;Poh, Ernest;Stevenson, Ellen;Mann, J. John;Galfalvy, Hanga
估计未来重性抑郁发作（MDE）的可能性将有助于临床医生就MDE的最佳治疗时间做出决策。不幸的是，很少有数据可用于指导临床实践。我们随访了200名女性和152名男性，他们对MDE治疗有反应，为期2年，以确定未来MDE的风险因素。考克斯比例风险回归模型的时间首次复发到MDE和混合效应逻辑回归模型每月抑郁状态。在研究的任何月份，女性比男性更有可能经历MDE，并且更有可能复发。到12个月时，60%的女性复发，而男性为51%（复发的中位时间分别为8个月和13个月）。有几个因素预测了男性和女性的不良结局：报告的儿童虐待，首次MDE发病年龄较早，双相情感障碍，失业和更多年的教育。对于女性，而不是男性，自杀意念预测MDE复发，自杀意念和既往自杀企图与MDE的时间更长相关。对参与者的自然主义治疗，排除当前患有酒精或物质使用障碍的个人，以及两年的随访期是有限的。与男性相比，女性更容易复发，抑郁的时间更长。识别未来抑郁症的一般和性别特异性风险因素可能为临床医生提供有用的工具，以估计MDE患者是否需要持续的药物治疗。
Estimating the likelihood of future major depressive episodes (MDEs) would assist clinicians in decision-making regarding the optimal length of treatment for MDE. Unfortunately, little data are available to guide clinical practice. We followed 200 females and 152 males who responded to treatment for a MDE for 2 years to determine risk factors for future MDE. Cox Proportional Hazard Regression modeled time to first relapse into MDE and mixed effect logistic regression modeled monthly depression status. Females were more likely than males to experience a MDE in any month of the study, and marginally more likely to experience a relapse. By 12 months, 60% of females had relapsed compared to 51% of males (median time to relapse 8 vs 13 months, respectively). Several factors predicted worse outcome for both men and women: reported childhood abuse, earlier age of onset of first MDE, Bipolar Disorder, unemployment, and more years of education. For females, but not males, suicidal ideation predicted MDE relapse and both suicidal ideation and prior suicide attempts were associated with more time in a MDE. The naturalistic treatment of participants, exclusion of individuals with current comorbid alcohol or substance use disorder, and a follow up period of two years are limitations. Women are more vulnerable to relapse and spend more time depressed compared to men. Identification of general and sex-specific risk factors for future depression may provide clinicians with useful tools to estimate need for ongoing pharmacotherapy in MDE.
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影响因子：
17.7
作者：
Keller, Matthew C.;Neale, Michael C.;Kendler, Kenneth S.
通讯作者：
Kendler, Kenneth S.
影响因子：
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作者：
Duggan, C;Sham, P;Murray, R
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GONZALES, LR;LEWINSOHN, PM;CLARKE, GN
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CLARKE, GN
影响因子：
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BECK, AT;KOVACS, M;WEISSMAN, A
通讯作者：
WEISSMAN, A
影响因子：
5.9
作者：
Ilardi, SS;Craighead, WE;Evans, DD
通讯作者：
Evans, DD