Persistence of chronic major depression: A national prospective study
Persistence of chronic major depression: A national prospective study
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DOI：
10.1016/j.jad.2013.06.013
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发表时间：
2013-10-01
影响因子：
6.6
通讯作者：
Blanco, Carlos
中科院分区：
文献类型：
--
作者：
Garcia-Toro, Mauro;Rubio, Jose M.;Blanco, Carlos
背景：慢性重度抑郁障碍(CMDD)非常普遍，并与高昂的个人和社会成本相关。确定CMDD持续和缓解的危险因素可能有助于开发更有效的治疗和预防干预措施。方法：对参加全国酒精及相关疾病流行病学调查(第1波；n=43,093)及其3年随访(第2波；34,653)的符合第1波CMDD诊断标准的个人进行前瞻性队列研究。结果：在符合第1波CMDD标准的504名受访者中，只有63人(11.52%)继续符合CMDD标准。儿童期性虐待史、较早发病的MDD、合并疾病和抑郁症就诊史预测CMDD在基线评估后三年内持续存在。限制：我们的样本仅限于成人，我们的随访期仅为三年，基线时CMDD的诊断是回顾的。结论：CMDD在基线评估的三年内显示出很高的缓解率，尽管一些特定的危险因素预测了持续的病程。鉴于与慢性MDD相关的高昂的个人和社会成本，有必要制定和传播有效的CMDD干预措施。(C)2013 Elsevier B.V.保留所有权利，
Background: Chronic major depressive disorder (CMDD) is highly prevalent and associated with high personal and societal cost. Identifying risk factors for persistence and remission of CMDD may help in developing more effective treatment and prevention interventions.Methods: Prospective cohort study of individuals participating in the National Epidemiologic Survey on Alcohol and Related Conditions (Wave 1; n=43,093) and its 3-year follow-up (Wave 2; n=34,653) who met a diagnosis of CMDD at the Wave 1 assessment.Results: Among the 504 respondents who met criteria for present CMDD at Wave 1, only 63 (11.52%) of them continued to meet criteria of CMDD. A history of childhood sexual abuse, earlier onset of MDD, presence of comorbidity and a history of treatment-seeking for depression predicted persistence of CMDD three years after the baseline evaluation.Limitations: Our sample is limited to adults, our follow-up period was only three-years and the diagnosis of CMDD at baseline was retrospective.Conclusions: CMDD shows high rates of remission within three years of baseline assessment, although some specific risk factors predict a persistent course. Given the high personal and societal cost associated with CMDD, there is a need to develop and disseminate effective interventions for CMDD. (C) 2013 Elsevier B.V. All rights reserved,