Atypical depressive syndromes in varying definitions
Atypical depressive syndromes in varying definitions
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DOI：
10.1007/s00406-005-0600-z
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发表时间：
2006-02-01
影响因子：
4.7
通讯作者：
Rössler, W
中科院分区：
文献类型：
--
作者：
Angst, J;Gamma, A;Rössler, W
背景非典型抑郁症（AD）在性别、双相情感障碍、遗传和神经生物学方面表现出不同的模式。使用前瞻性数据从社区样本，本文确定了标准（和相关）的AD综合征，最大限度地提高与女性性别和双极-II。方法苏黎世队列研究由591名受试者组成，这些受试者选自瑞士苏黎世州以人群为基础的年轻成年人队列，于1978年进行筛选，随后在1999年进行了6次访谈。非典型抑郁症的七个定义进行了测试，使用不同的组合植物人症状和情绪反应。结果以疲劳、暴饮暴食、过度睡眠3项中的2项或2项中的2项（暴饮暴食、过度睡眠）植物性症状为非典型定义，与性别、双相情感障碍和躁狂家族史的相关性最强。选择2/3定义进行进一步分析，因为它对识别这些特征具有高灵敏度。该综合征的累积加权患病率为16.4%（男性9.7%，女性23%）;当与重度抑郁发作相关时，为8.2%（男性3.2%，女性15.1%）。AD患者的特点是治疗率高，严重程度高，工作障碍，发病年龄早，病程长。AD与社交恐惧症、暴食、神经衰弱、偏头痛和主观认知障碍共病。
Background Atypical depression (AD) exhibits distinct patterns of gender, bipolar-II disorder, genetic, and neuro-biological measures. Using prospective data from a community sample, this paper identifies criteria (and correlates) for an AD syndrome that maximizes the association with female sex and bipolar-II. Methods The Zurich cohort study is composed of 591 subjects selected from a population-based cohort of young adults in the canton of Zurich in Switzerland, screened in 1978 and followed with six interviews through 1999. Seven definitions of atypical depression were tested, using varying combinations of vegetative symptoms and mood reactivity. Results The atypical definitions using 2 of 3 (fatigue, overeating, oversleeping) or 2 of 2 (overeating, oversleeping) vegetative symptoms showed the strongest association with gender, bipolarity, and family history of mania. The 2/3 definition was chosen for further analysis due to its high sensitivity for identifying these characteristics. This syndrome had cumulated weighted prevalence of 16.4% (males 9.7%, females 23%); when associated with major depressive episodes, 8.2% (males 3.2%, females 15.1%). AD patients were characterized by high treatment rates, severity, and work impairment, early age of onset and long illness. AD was comorbid with social phobia, binge eating, neurasthenia, migraine headache, and subjective cognitive impairment.