Do anxiety symptoms predict major depressive disorder in midlife women? The Study of Women's Health Across the Nation (SWAN) Mental Health Study (MHS).
Do anxiety symptoms predict major depressive disorder in midlife women? The Study of Women's Health Across the Nation (SWAN) Mental Health Study (MHS).
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DOI：
10.1017/s0033291714000075
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发表时间：
2014-09
影响因子：
6.9
通讯作者：
Bromberger, J. T.
中科院分区：
文献类型：
--
作者：
Kravitz, H. M.;Schott, L. L.;Joffe, H.;Cyranowski, J. M.;Bromberger, J. T.
在女性中，焦虑症状很常见，并且在中年时期会增加，但很少有人知道这些症状是否能预测重度抑郁症（MDD）发作。我们研究了焦虑症状是否与中年非裔美国人和白种人妇女随后的MDD发作有关，以及它们是否赋予首次与复发性MDD发作不同的风险。对全国妇女健康研究（SWAN）心理健康研究（MHS）的12年数据进行了纵向分析。基线样本包括425名白人（n=278）和非裔美国人（n=147）社区居住妇女，年龄为46.1±2.5岁。每年使用自我报告问卷测量焦虑症状，并在随后的一年检查与重度抑郁症发作的关系，用SCID进行评估。采用随机效应logistic回归对多变量模型进行估计。较高的焦虑症状评分与随后的年度就诊中发生重度抑郁症发作的调整后几率显著升高相关[比值比（OR） 1.47, p=0.01]，特别是对于复发发作（OR 1.49, p=0.03），但对于首次发作不显著（OR 1.32, p=0.27）。在焦虑症状和随后的重度抑郁症发作之间没有明显的种族影响。焦虑症状通常先于重度抑郁症，并可能增加中年妇女抑郁发作的脆弱性，特别是复发。有焦虑症状的妇女应该在接下来的一年里进行临床监测，以防重度抑郁症发作。
In women, anxiety symptoms are common and increase during midlife, but little is known about whether these symptoms predict onsets of major depressive disorder (MDD) episodes. We examined whether anxiety symptoms are associated with subsequent episodes of MDD in midlife African-American and Caucasian women, and whether they confer a different risk for first versus recurrent MDD episodes. A longitudinal analysis was conducted using 12 years of data from the Study of Women’s Health Across the Nation (SWAN) Mental Health Study (MHS). The baseline sample comprised 425 Caucasian (n=278) and African American (n=147) community-dwelling women, aged 46.1±2.5 years. Anxiety symptoms measured annually using a self-report questionnaire were examined in relation to MDD episodes in the subsequent year, assessed with the SCID. Multivariable models were estimated with random effects logistic regression. Higher anxiety symptoms scores were associated with a significantly higher adjusted odds of developing an episode of MDD at the subsequent annual visit [odds ratio (OR) 1.47, p=0.01], specifically for a recurrent episode (OR 1.49, p=0.03) but non-significant for a first episode (OR 1.32, p=0.27). There were no significant racial effects in the association between anxiety symptoms and subsequent MDD episodes. Anxiety symptoms often precede MDD and may increase the vulnerability of midlife women to depressive episodes, particularly recurrences. Women with anxiety symptoms should be monitored clinically during the ensuing year for the development of an MDD episode.