The factor structure of lifetime depressive spectrum in patients with unipolar depression
The factor structure of lifetime depressive spectrum in patients with unipolar depression
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DOI：
10.1016/j.jad.2008.09.006
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发表时间：
2009-05-01
影响因子：
6.6
通讯作者：
Frank, E.
中科院分区：
文献类型：
--
作者：
Cassano, G. B.;Benvenuti, A.;Frank, E.
背景：虽然之前试图阐明抑郁症的因素结构倾向于将焦点集中在抑郁情绪上，但其他因素并没有在研究中得到重复。通过检查涵盖抑郁症状范围的大量项目的数据，本研究的目的是有助于从一生的角度确定抑郁症的结构。方法：研究样本包括598例单极抑郁症患者，他们使用意大利语（N=415）或英语（N=183）进行心境谱自我报告（终身版）。在传统的四分频相关系数探索性因子分析的基础上，采用基于irt的因子分析方法对74项与抑郁相关的认知、情绪和能量/活动特征的数据进行分析。结果：确定了“抑郁情绪”、“精神运动迟缓”、“自杀倾向”、“药物/疾病相关抑郁”、“精神病特征”和“神经植物症状”6个因素，占项目方差的48.3%。局限性：有关抑郁症发病和病程的临床信息仅为350名受试者。因此，使用可用数据只能部分解释站点之间的差异。结论：我们的研究证实了抑郁情绪、精神运动迟缓和自杀的核心作用，并确定了“药物/疾病相关抑郁”、“精神病特征”和神经植物失调等因素，这些因素在以前的研究中最常用的工具中没有被捕捉到。在多种因素上识别具有特定特征的患者可能有助于在神经影像学研究中获得更高的精度，并为治疗选择提供信息。(C) 2008 Elsevier b.v.版权所有
Background: While previous attempts to elucidate the factor structure of depression tended to agree on a central focus on depressed mood, other factors were not replicated across studies. By examining data from a large number of items covering the range of depressive symptoms, the aim of the present study is to contribute to the identification of the structure of depression on a lifetime perspective.Methods: The study sample consisted of 598 patients with unipolar depression who were administered the Mood Spectrum Self-Report (lifetime version) in Italian (N=415) or English (N=183). In addition to classical exploratory factor analysis using tetrachoric correlation coefficients, an IRT-based factor analysis approach was adopted to analyze the data on 74 items of the instrument that explore cognitive, mood and energy/activity features associated with depression.Results: Six factors were identified, including 'Depressive Mood', 'Psychomotor Retardation', 'Suicidality', 'Drug/Illness related depression', 'Psychotic Features' and 'Neurovegetative Symptoms', accounting overall for 48.3% of the variance of items. Limitations: Clinical information on onset of depression and duration of illness is available only for 350 subjects. Therefore, differences between sites can only be partially accounted using available data.Conclusions: Our study confirms the central role of depressed mood, psychomotor retardation and suicidality and identifies the factors 'Drug/Illness related depression', 'Psychotic features' and the neurovegetative dysregulation not captured by the instruments most frequently used in previous studies. The identification of patients with specific profiles on multiple factors may be useful in achieving greater precision in neuroimaging studies and in informing treatment selection. (C) 2008 Elsevier B.V All rights reserved.