Subthreshold depression and depressive disorder: clinical characteristics of general medical and mental health specialty outpatients.
Subthreshold depression and depressive disorder: clinical characteristics of general medical and mental health specialty outpatients.
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阈下抑郁症和抑郁症：普通医疗和心理健康专科门诊患者的临床特征。
DOI：
10.1176/ajp.151.12.1777
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发表时间：
1994
期刊：
影响因子：
--
通讯作者：
Judd,LL
中科院分区：
文献类型：
--
作者：
Sherbourne,CD;Wells,KB;Hays,RD;Rogers,W;Burnam,MA;Judd,LL
目的作者检验了门诊样本中低于抑郁症阈值的抑郁症状的临床意义。方法研究对象包括 775 名目前患有抑郁症的成年患者、1,420 名阈下抑郁症患者以及 1,767 名伴或不伴抑郁的高血压患者，他们都在美国三个城市的心理健康专家和普通医疗保健提供者的办公室就诊。比较抑郁症患者和阈下抑郁症患者的人口特征、抑郁严重程度、精神和医学合并症程度、家族精神病史和治疗史。结果有抑郁症家族史的阈下抑郁症患者比例（41%）几乎与抑郁症患者（59%）一样高。两组患者的医疗和精神合并症水平相似，但焦虑症除外，抑郁症患者的焦虑症程度更高。在全科医疗部门的高血压患者中，与非抑郁性高血压患者相比，阈下抑郁症患者与抑郁症患者更相似。在普通医疗部门，阈下抑郁症患者的治疗率明显低于抑郁症患者，但在心理健康专业部门的治疗率相似。结论在这些门诊患者中，阈下抑郁症似乎是情感障碍的一种变体，在心理健康专业部门接受治疗，但在普通医疗部门则不然。研究结果强调了阈下抑郁症患者治疗结果研究的重要性。
ObjectiveThe authors examined the clinical significance of depressive symptoms below the threshold for depressive disorder in outpatient samples.MethodThe subjects were 775 adult patients with current depressive disorder, 1,420 patients with subthreshold depression, and 1,767 hypertensive patients with and without depression, all of whom were visiting the offices of mental health specialists and general medical care providers in three US cities. Data on demographic characteristics, severity of depression, extent of psychiatric and medical comorbidity, family psychiatric history, and treatment history for the patients with depressive disorder and those with subthreshold depression were compared.ResultsThe percentage of patients with subthreshold depression who had a family history of depression (41%) was nearly as high as that of the patients with depressive disorder (59%). The two groups of patients had similar levels of medical and psychiatric comorbidity except for anxiety disorders, which were greater among the patients with depressive disorder. Among the hypertensive patients in the general medical sector, those with subthreshold depression were more similar to those with depressive disorder than to the nondepressed hypertensive patients. Treatment rates were considerably lower for patients with subthreshold depression than for patients with depressive disorder in the general medical sector, but they were similar in the mental health specialty sector.ConclusionsIn these outpatients, subthreshold depression appeared to be a variant of affective disorder and was treated as such in the mental health specialty sector but not in the general medical sector. The findings emphasize the importance of treatment outcome studies of patients with subthreshold depression.