ANXIETY--A PREDICTOR OF OUTCOME IN DEPRESSION?

这项修订提案的目的是审查亲属 抑郁和焦虑症状对 预测非精神病性重度抑郁症受试者的预后。 这项研究是前瞻性的纵向评估和随访 在60名受试者中，有不超过2次先前的离散发作 重度抑郁症&目前正在经历中重度抑郁 抑郁和焦虑。情感和焦虑症状将被评估 每个月，焦虑的预测值将被确定。 症状的时间变化将在一个 一年(或直到复发)以确定是否缓解和 抑郁症的复发/复发可以预测。要测试 一种假设，即焦虑的改善预示着 抑郁症，将解决3个具体和相关的问题：(1) 治疗前(和安慰剂前)焦虑水平的程度 预测抑郁症状的改善；(2) 抑郁症状的改善可作为潜伏期的预测指标 临床缓解及其与多种预治疗的关系 变量，包括焦虑和其他一些独立变量 将被转化为单一的“复发倾向”的变量 焦虑症状的应答率和残余水平 焦虑是抑郁症复发的时间预测因子。潜力 该项目与健康的相关性关系到 这种关系可能会建议合理的治疗方法&更好的 对情感性精神障碍辨证论治的认识 反应和预后。人格障碍等相关因素 情绪症状/障碍或药物滥用的家族史可能是 与治疗反应不完全有关。尽管这不是 治疗研究，受试者最初将参与正在进行的 在我们的治疗研究单位学习，并将为此招聘 在治疗前进行研究；药物研究通常持续6周。 前期筛查将包括SADS-RDC诊断和FH-RDC。 自评PDQ-R和艾森克个性问卷将是 管理以确定个性测量、评分者和自我报告 将完成抑郁症和焦虑量表。跟进 症状变化将用SADS-C和抑郁& 焦虑量表，每月一次；受试者将按时间付费。 Bock的随机回归模型和Cox回归将被用于 检查改善率、抑郁与抑郁的关系 焦虑症状，以及缓解和复发的时间。二次分析 将检验个别项目，以及收敛和区分效度 焦虑和抑郁。

The aim of this REVISED proposal is to examine the relative contribution that depressive & anxiety symptoms make to the prediction of outcome in subjects with nonpsychotic major depression. The study is to be a prospective longitudinal assessment & follow-up of 60 subjects with not more than 2 pervious discrete episodes of major depression & currently experiencing moderately severe depression & anxiety. Affective & anxiety symptoms will be assessed monthly, and the predictive value of anxiety will be determined. Temporal changes in symptoms will be examined over the course of a year (or until recurrence) to determine whether remission and relapse/recurrence of depression can be predicted. To test the hypothesis that improvement in anxiety predicts improvement in depression, 3 specific & related questions will be addressed: (1) the degree to which pretreatment (&pre-placebo) anxiety levels predict improvement in depressive symptoms; (2) the rate of improvement of depressive symptoms as a predictor of latency to clinical remission & its relationship to a number of pretreatment variables, including anxiety & a number of other independent variables that will be transformed into a single "relapse propensity score"; & (3) response rate of anxiety symptoms & residual levels of anxiety as predictors of time to depressive relapse. The potential health relatedness of this project concerns the predictability of the relationship may suggest rational therapeutic approaches & a better understanding for classifying affective disorders based on treatment responses & prognosis. Related factors such as personality disorders & family history of mood symptoms/disorders or substance abuse may be associated with incomplete treatment response. Though this is not a treatment study, subjects will initially be involved in an ongoing study in our Treatment Research Unit, & will be recruited for this study prior to treatment; drug studies usually last 6 weeks. Pretreatment screening will include a SADS-RDC diagnosis & FH-RDC. the self-rated PDQ-R & Eysenck Personality Inventory will be administered to ascertain personality measures, & rater-&self-report depression & anxiety inventories will be completed. Follow-up symptom change will be assessed with the SADS-C & depression & anxiety scales, monthly; subjects will be paid for their time. Bock's random regression model & Cox regression will be used to examine rates of improvement, relationship between depressive & anxiety symptoms, & time to remissions & relapse. Secondary analyses will examine individual items, & convergent & discriminant validity of anxiety & depression.