Depression, anxiety and somatic distress: syndromal structure and relationship to onset of clinical disorder

该项目旨在确定心理困扰（消极情绪状态，如抑郁、焦虑、压力和疲劳）的主要方面或潜在症状。我们计划使用密集的纵向设计来检查这些综合征如何发展成临床障碍的发作。我们期望，疾病发作不仅可以通过密切相关的综合症来预测，还可以通过其他因果相关的综合症来预测——例如，一段时间的焦虑和压力增加可能会导致抑郁症。这一信息对于理解临床疾病的病因学、完善诊断标准、预测和预防疾病都很重要。我们还计划收集有关人们遭受的残疾程度以及他们在每种综合症的不同严重程度上获得的保健服务类型的信息。我们预计，一些综合征的亚临床水平将与严重损害和服务使用有关，但对于其他综合征，损害将最小，直到达到临床严重程度。这一信息将使人们更全面地了解整个社区的情绪困扰负担，并将与卫生规划和政策直接相关。

The project aims to identify the principal dimensions or syndromes underlying symptoms of psychological distress (negative emotional states such as depression, anxiety, stress and fatigue). We plan to use an intensive longitudinal design to examine how these syndromes develop into episodes of clinical disorder. We expect that episodes of disorder will be predicted not only by closely related syndromes, but also by other causally related syndromes - for example, a period of increased anxiety and stress may precipitate a depressive disorder. This information is important for understanding the aetiology of clinical disorders, for refining diagnostic criteria, and for the prediction and prevention of disorder. We also plan to collect information about the degree of disability that people suffer and the type of health services they access at various levels of severity of each syndrome. We expect that subclinical levels of some syndromes will be associated with substantial impairment and service usage, but that for other syndromes impairment will be minimal until clinical levels of severity are reached. This information will give a more complete picture of the community-wide burden of emotional distress, and will be directly relevant to health planning and policy.