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

该项目的目的是确定心理痛苦症状的主要方面或综合征（消极情绪状态，如抑郁、焦虑、压力和疲劳）。我们计划使用一个密集的纵向设计来研究这些综合征如何发展成临床疾病的发作。我们预期，不仅可以通过密切相关的综合征来预测疾病的发作，还可以通过其他因果相关的综合征来预测疾病的发作--例如，一段时间的焦虑和压力增加可能会导致抑郁症。这些信息对于理解临床疾病的病因学、完善诊断标准以及疾病的预测和预防都很重要。我们还计划收集关于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下获得的卫生服务类型的信息。我们预计某些综合症的亚临床水平将与实质性损害和服务使用相关，但对于其他综合症，在达到临床严重程度之前，损害将很小。这些信息将更全面地反映整个社区的精神痛苦负担，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.