Long-term course of severe depression: late remission and recurrence may be found in a follow-up after 38-53 years.
Long-term course of severe depression: late remission and recurrence may be found in a follow-up after 38-53 years.
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DOI：
10.4081/mi.2012.e17
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发表时间：
2012-07-26
期刊：
影响因子：
6.3
通讯作者：
Brådvik L
中科院分区：
文献类型：
--
作者：
Crona L;Brådvik L
这项研究是对1956至1969年间被诊断为严重抑郁症/忧郁症的住院患者的随访。在此期间，伦德大学医院精神病科的所有住院患者在出院时都接受了多维诊断计划的评级。1920年以后出生的患者有471人。在目前的后续行动中，从2006年到2010年，可以追踪到169名幸存者。他们被要求参与这项研究，其中包括一次电话采访，其中使用了结构化的生活图表。在联系的患者中，16人生病或精神错乱，3人不记得曾患过抑郁症，剩下150人可以参与。其中75人同意参与这项研究。通过聚类分析对抑郁的长期病程进行评估，并与背景变量进行比较，如抑郁的遗传、父母教养方式的感知和指标性抑郁发作的治疗。使用聚类分析，患者可分为六组描述病程：i)单个或少数发作，随后长期缓解；ii)单个或少数发作，随后长期缓解，尽管时间较短；iii)单个或少数发作，随后晚期复发；iv)单个或少数发作，但更频繁地生病，随后晚期复发；v)若干发作，随后持久缓解；vi)慢性发作。因此，即使在十多年后，也可能出现缓解或复发。总而言之，有一个有或没有复发的短期病程，或有或没有晚期缓解的慢性病程。抑郁症的遗传与有或没有晚期缓解的慢性病程显著相关。
This study is a follow-up of inpatients diagnosed with severe depression/melancholia between 1956 and 1969. During this period, all inpatients at the Department of Psychiatry, University Hospital, Lund, were rated on a multidimensional diagnostic schedule on discharge. There were 471 patients born from 1920 onward. In the present follow-up, 2006 to 2010, 169 survivors could be traced. They were asked to participate in the study involving a telephone interview, in which a structured life chart was used. Of the patients contacted, 16 were ill or confused and 3 did not remember ever being depressed, leaving 150 who could participate. Seventy-five of these agreed to participate in the study. Long-term course of depression was evaluated by cluster analysis and compared to background variables, such as heredity for depression, perceived parental rearing behaviour, and treatment of index depressive episode. Using a cluster analysis the patients could be separated into six clusters describing the course: i) single or few episodes followed by long-lasting remission; ii) single or few episodes followed by long-lasting remission, although shorter; iii) single or few episodes followed by late recurrence; iv) single or few episodes, but more frequently ill, followed by late recurrence; v) several episodes followed by lasting remission; vi) chronic course of episodes. Remission or recurrence could therefore occur even after more than a decade. In summary, there was a short-term course with or without recurrence or a chronic course with or without late remission. Heredity for depression was significantly related to a chronic course with or without late remission.