Premenstrual exacerbation of depressive disorders in community-based sample in the United States
Premenstrual exacerbation of depressive disorders in community-based sample in the United States
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DOI：
10.1097/01.psy.0000138131.92408.b9
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发表时间：
2004-09-01
影响因子：
3.3
通讯作者：
Kravitz, HM
中科院分区：
文献类型：
--
作者：
Hartlage, SA;Brandenburg, DL;Kravitz, HM
目的：尚未有已发表的流行病学研究在代表性样本中检测经前抑郁障碍加重（PME-DD）。所获得的知识应表明疾病负担，建议监测对象，并促进诊断。目的是1）确定PME-DD的患病率和预测因子;和2）测试竞争性假设，即PME-DD与a）抑郁症的严重程度或病史，B）一般女性的月经周期，或c）方法学人为因素有关。居住在伊利诺伊州城市或农村的13至53岁的月经女性（N = 900）完成了半结构化的精神病学诊断访谈和抑郁症的症状，每天评定两个月经周期; 58人有严重抑郁症，心境恶劣，或亚临床抑郁症，其余842人是代表性样本的非抑郁部分。抑郁女性有1.34（95%置信区间，1.02类似于1.66）症状恶化产前。预测急性加重的最佳模型仅包含年龄。老年妇女的症状更经常恶化。在卵泡期的症状对于临床抑郁症是最严重的，对于亚临床抑郁症是中等的，对于非抑郁症参与者是最不严重的，ps < 0.001。与所有女性的恶化与周期性相关的假设一致，各组之间恶化的症状数量没有差异，ps < 0.46。如果在一个周期中没有症状，那么在下一个周期中出现症状的几率为0.91。只有56%的非抑郁症的女性服用抗抑郁药是无症状的所有一个月之久，其余的44%仍然有症状preterritualy.Conclusions：经前抑郁症的恶化与功能恶化以上，已经经历了抑郁症的女性。无论抑郁症的严重程度、发作次数或缓解状态如何，患者都可能易感。
Objective: No published epidemiologic study has examined premenstrual exacerbation of depressive disorders (PME-DD) in a representative sample. Knowledge gained should indicate the burden of illness, suggest whom to monitor, and facilitate diagnosis. The objectives were to 1) ascertain the prevalence and predictors of PME-DD; and 2) test competing hypotheses that PME-DD is related to a) severity or history of depression, b) menstrual cyclicity in females in general, or c) a methodological artifact.Methods: Menstruating females (N = 900) from ages 13 to 53 living in urban or rural Illinois completed semi-structured psychiatric diagnostic interviews and rated symptoms of depression daily for two menstrual cycles; 58 had major depressive, dysthymic, or subclinical depressive disorders, and the remaining 842 were the non-depressed portion of the representative sample.Results: Depressed females had 1.34 (95% confidence interval, 1.02 similar to 1.66) symptoms exacerbated premenstrually. The best model for predicting exacerbation contained only age. Older women more often had symptoms worsen. Symptoms during the follicular phase were most severe for clinically depressed, intermediate for subclinically depressed, and least severe for non-depressed participants, ps < 0.001. Consistent with the hypothesis that exacerbation is related to cyclicity in all females, the number of symptoms that became worse did not differ between groups, ps < 0.46. Given no symptoms in one cycle, the odds of having symptoms in the next cycle were 0.91. Only 56% of non-depressed females taking antidepressants were asymptomatic all month long; the remaining 44% still had symptoms premenstrually.Conclusions: Premenstrual exacerbation of depressive disorders is associated with deteriorated functioning over and above that already experienced by depressed females. Patients may be susceptible regardless of severity of depression, number of episodes, or remission status.