MAJOR DEPRESSION OR UNCOMPLICATED BEREAVEMENT - A FOLLOW-UP OF YOUTH EXPOSED TO SUICIDE
MAJOR DEPRESSION OR UNCOMPLICATED BEREAVEMENT - A FOLLOW-UP OF YOUTH EXPOSED TO SUICIDE
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DOI：
10.1097/00004583-199402000-00012
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发表时间：
1994-02-01
影响因子：
13.3
通讯作者：
CANOBBIO, R
中科院分区：
文献类型：
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作者：
BRENT, DA;PERPER, JA;CANOBBIO, R
目标：通过检查复发性重性抑郁症的纵向风险，确定暴露于自杀的青年所经历的抑郁反应是单纯的丧亲之痛还是重性抑郁症。方法：26名青少年自杀受害者的121名朋友和熟人在自杀受害者死亡后约6个月进行了初步采访后1至18个月进行了随访。一个人口统计学上相似的138名未暴露的对照组也进行了随访。结果：37名暴露后抑郁的受试者中位抑郁持续时间为8个月。与对照组相比，暴露组在随访期间有更高的抑郁事件发生率（RR = 1.7，95%CI = 1.0 - 2.8），即使在调整了既往抑郁症史和其他抑郁症风险因素后。在暴露受试者组中，在暴露于自杀之前出现抑郁症的受试者中，随访时抑郁症的发生率最高，在暴露后出现抑郁症的受试者中，抑郁症的发生率居中，而在暴露后第一次访谈时没有抑郁症的受试者中，抑郁症的发生率最低。在随访时，没有证据表明暴露组的自杀企图发生率高于未暴露对照组。结论：根据病程和复发风险，在有自杀倾向的青年中观察到的抑郁反应与重度抑郁发作最为一致。暴露于自杀与复发性抑郁症的风险增加有关，但与自杀行为的长期风险增加无关。
Objective: To determine whether the depressive reactions experienced by youth exposed to suicide were uncomplicated bereavement or major depression by examining the longitudinal risk of recurrent major depression. Method: The 121 friends and acquaintances of 26 adolescent suicide victims were followed up 1 to 18 months after an initial interview that took place around 6 months after the death of the suicide victim. A demographically similar group of 138 unexposed controls was also followed up. Results: The median duration of depression in the 37 subjects who became depressed after exposure was 8 months. The exposed group, compared with controls, had a higher rate of incident depression (RR = 1.7, 95% CI = 1.0-2.8) during the follow-up period, even after adjustment for previous history of depression and other risk factors for depression. Within the group of exposed subjects, the rate of depression on follow-up was highest in those who developed a depressive disorder before exposure to suicide, intermediate in those who developed depression after exposure, and lowest in those who were not depressed at the first interview after exposure. There was no evidence of an increased incidence of suicide attempts in the exposed group relative to the unexposed controls on follow-up. Conclusions: The depressive reactions observed in youth exposed to suicide are most consistent with major depressive episodes on the basis of course and risk of recurrence. Exposure to suicide was associated with an increased risk of recurrent depression but not with an increased long-term risk of suicidal behavior.