The impact of somatic symptoms on the course of major depressive disorder
The impact of somatic symptoms on the course of major depressive disorder
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DOI：
10.1016/j.jad.2016.06.030
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发表时间：
2016-11-15
影响因子：
6.6
通讯作者：
Schoevers, Robert A.
中科院分区：
文献类型：
--
作者：
Bekhuis, Ella;Boschloo, Lynn;Schoevers, Robert A.
目的：躯体症状对抑郁症（MDD）的病程有负面影响。然而，这种联系背后的机制仍然难以捉摸。本研究探讨躯体症状对MDD预后的影响，旨在确定这种影响是否可以通过精神特征、躯体疾病、生活方式因素和残疾来解释。463例MDD患者（平均年龄=44.9岁，69.8%为女性），来自荷兰抑郁和焦虑研究（NESDA），我们检验了躯体症状群的类型和数量是否能预测MDD的两年持续性。采用复合国际诊断访谈法（CIDI）诊断抑郁症，采用四维症状问卷（4DSQ）躯体化量表评定躯体症状群。结果：心肺、胃肠道和全身因素可显著预测MDD的2年持续性，但仅当存在两个或两个以上这些因素时（OR=2.32，95%CI =1.5-3.57，p= 0.001）。
Objective: Somatic symptoms have been suggested to negatively affect the course of major depressive disorder (MDD). Mechanisms behind this association, however, remain elusive. This study examines the impact of somatic symptoms on MDD prognosis and aims to determine whether this effect can be explained by psychiatric characteristics, somatic diseases, lifestyle factors, and disability.Methods: In 463 MDD patients (mean age=44.9 years, 69.8% female) from the Netherlands Study of Depression and Anxiety (NESDA), we examined whether the type and number of somatic symptom clusters predicted the two-year persistence of MDD. Diagnoses of MDD were established with the Composite International Diagnostic Interview (CIDI) and somatic symptom clusters were assessed with the Four-Dimensional Symptom Questionnaire (4DSQ) somatization scale. Psychiatric characteristics, somatic diseases, lifestyle factors, and disability were taken into account as factors potentially underlying the association.Results: The cardiopulmonary, gastrointestinal, and general cluster significantly predicted the two-year persistence of MDD, but only when two or more of these clusters were present (OR=2.32, 95% CI=1.5-3.57, p=