Functioning and well-being outcomes of patients with depression compared with chronic general medical illnesses.
Functioning and well-being outcomes of patients with depression compared with chronic general medical illnesses.
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DOI：
10.1001/archpsyc.1995.03950130011002
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发表时间：
1995
影响因子：
--
通讯作者：
Ron D. Hays;K. Wells;C. Sherbourne;W. Rogers;K. Spritzer
中科院分区：
文献类型：
--
作者：
Ron D. Hays;K. Wells;C. Sherbourne;W. Rogers;K. Spritzer
背景
横断面研究发现，抑郁症与幸福感和功能受限存在独特关联，这种受限程度等于或大于糖尿病和关节炎等慢性普通内科疾病。然而，这些相对受限情况是否会随时间持续存在尚不清楚。
方法
我们对1790名患有抑郁症、糖尿病、高血压、近期心肌梗死和/或充血性心力衰竭的成年门诊患者进行了一项为期2年的观察性研究。对抑郁症患者与慢性普通内科疾病患者的功能状态和幸福感变化进行了比较，并对共病情况、社会人口统计学特征、医疗体系以及医疗专科进行了统计控制。
结果
在2年的随访中，抑郁症患者的功能和幸福感受限情况有所改善；即便如此，在2年结束时，这些受限情况与慢性内科疾病所致的受限情况相似或更糟。在精神卫生专科部门的抑郁症患者和普通内科部门的抑郁症患者中观察到了类似模式，但精神卫生专科部门的患者改善更多。抑郁症更严重的患者在功能方面改善更多，但即使是最初没有抑郁症的抑郁症患者也存在大量持续受限情况。
结论
抑郁症患者在功能和幸福感的多个方面存在大量且持久的下降，其程度等于或超过慢性内科疾病患者。
BACKGROUND Cross-sectional studies have found that depression is uniquely associated with limitations in well-being and functioning that were equal to or greater than those of chronic general medical conditions such as diabetes and arthritis. However, whether these relative limitations persist over time is not known. METHODS We conducted a 2-year observational study of 1790 adult outpatients with depression, diabetes, hypertension, recent myocardial infarction, and/or congestive heart failure. Change in functional status and well-being was compared for depressed patients vs patients with chronic general medical illnesses, controlling statistically for medical comorbidity, sociodemographics, system, and specialty of care. RESULTS Over 2 years of follow-up, limitations in functioning and well-being improved somewhat for depressed patients; even so, at the end of 2 years, these limitations were similar to or worse than those attributed to chronic medical illnesses. Similar patterns were observed for depressed patients in the mental health specialty sector and those in the general medical sector, but the patients in the mental health specialty sector improved more. More severely depressed patients improved more in functioning, but even initially depressed patients without depressive disorder had substantial persistent limitations. CONCLUSION Depressed patients have substantial and long-lasting decrements in multiple domains of functioning and well-being that equal or exceed those of patients with chronic medical illnesses.