Latent subtypes of depression in a community sample of older adults: can depression clusters predict future depression trajectories?
Latent subtypes of depression in a community sample of older adults: can depression clusters predict future depression trajectories?
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DOI：
10.1016/j.jpsychires.2013.05.033
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发表时间：
2013-10
影响因子：
4.8
通讯作者：
Blazer, Dan G.
中科院分区：
文献类型：
--
作者：
Hybels, Celia F.;Landerman, Lawrence R.;Blazer, Dan G.
识别晚年抑郁症的异质性来源仍然是精神病学调查的一个重要焦点。社区样本特别具有信息性，因为许多老年人有临床显著的抑郁症状，但不符合重度抑郁症的标准，老年人一般不寻求治疗他们的抑郁症状。用于这些分析的主要数据是在对3000多名65岁或以上成年人进行长达十年的社区调查中收集的数据。采用流行病学中心抑郁量表（CES-D）测量抑郁症状。潜在类别分析用于根据基线时的症状特征识别参与者的聚类。使用混合模型来检查基于聚类分配的CES-D评分的轨迹。具有三个唯一聚类的模型最适合数据。聚类1（59%）有任何症状认可的概率较低。聚类2（31%）赞同作为一个群体的一些负面影响和躯体症状，但他们的认可低积极影响没有从聚类1不同。与第1组和第2组相比，第3组（10%）的参与者对所有症状的认可概率更高。当包括症状严重程度时，结果没有明显差异。在10年的随访期内，聚类分配是CES-D评分变化的一个重要预测因素，随着时间的推移，性别的影响也不同。抑郁症的症状概况预测抑郁症的纵向过程中的一个社区样本的老年人，研究结果是重要的，特别是在初级保健设置。
Identifying sources of heterogeneity in late life depression remains an important focus of psychiatric investigation. Community samples are particularly informative since many older adults have clinically significant depressive symptoms but fail to meet criteria for major depression and older adults generally do not seek treatment for their depressive symptoms. The primary data used for these analyses were those collected in a community-based survey of over 3000 adults age 65 or older followed for up to ten years. Depressive symptoms were measured by the Center for Epidemiologic Studies-Depression scale (CES-D). Latent class analysis was used to identify clusters of participants based on their symptom profiles at baseline. Mixed models were used to examine trajectories of CES-D scores based on cluster assignment. A model with three unique clusters best fit the data. Cluster 1 (59%) had a low probability of any symptom endorsement. Cluster 2 (31%) endorsed as a group some negative affect and somatic symptoms but their endorsement of low positive affect did not differ from Cluster 1. Participants in Cluster 3 (10%) had a higher probability of endorsement of all symptoms compared to Clusters 1 and 2. The results did not appreciably differ when symptom severity was included. Cluster assignment was a significant predictor of change in CES-D score over the ten-year follow-up period, and the effects over time differed by sex. Depressive symptom profiles predict the longitudinal course of depression in a community sample of older adults, findings that are important especially in primary care settings.
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影响因子：
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