A prospective latent analysis study of Axis I psychiatric co-morbidity of DSM-IV major depressive disorder

被引:3
作者
Melartin, T. [1 ,2 ]
Mantere, O. [1 ,3 ]
Ketokivi, M. [4 ]
Isometsa, E. [1 ,2 ,5 ]
机构
[1] Natl Inst Hlth & Welf, Dept Mental Hlth & Subst Abuse Serv, Mood Depress & Suicidal Behav Unit, Helsinki, Finland
[2] Univ Helsinki, Cent Hosp, Dept Psychiat, FI-00014 Helsinki, Finland
[3] Univ Helsinki, Cent Hosp, Jorvi Hosp, Dept Psychiat, Espoo, Finland
[4] IE Business Sch, Operat & Technol Dept, Madrid, Spain
[5] Univ Helsinki, Dept Psychiat, FI-00014 Helsinki, Finland
关键词
Co-morbidity; latent curve models; major depressive disorder; prospective studies; COMMON MENTAL-DISORDERS; SUBSTANCE USE DISORDERS; NATIONAL EPIDEMIOLOGIC SURVEY; ENVIRONMENTAL RISK-FACTORS; ALCOHOL DEPENDENCE; ANXIETY DISORDERS; INTERNALIZING DISORDERS; UNITED-STATES; III-R; COMORBIDITY;
D O I
10.1017/S0033291713001694
中图分类号
B849 [应用心理学];
学科分类号
040203 ;
摘要
Background We tested the degree to which longitudinal observations fit two hypotheses of psychiatric co-morbidity in DSM-IV major depressive disorder (MDD) among adult patients: (1) Axis I co-morbidity is dependent on major depressive episode (MDE) course, and (2) Axis I co-morbidity is independent of MDE course. Method In the Vantaa Depression Study (VDS), 269 psychiatric secondary-care patients with a DSM-IV MDD were evaluated with the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) at intake and at 6 and 18 months. Three evaluations of co-morbidity were available for 193 out of 259 living patients (75%). A latent curve model (LCM) was used to examine individual-level changes in depressive and anxiety symptoms across time. Outcome of MDD was modeled in terms of categorical DSM-IV diagnosis and Beck Depression Inventory (BDI) and Hamilton Depression Rating Scale (HAMD) scores, and co-morbidity in terms of categorical DSM-IV anxiety and alcohol use disorder (AUD) diagnoses and Beck Anxiety Inventory (BAI) scores. Results Depression and anxiety correlated cross-sectionally at baseline. Longitudinally, changes in depression and anxiety correlated in both the 0-6 and 6-18 months time windows. Higher baseline depression raised the likelihood of an AUD at 6 months, and patients with more depressive symptoms in the 0-6 months time window were more likely to have had an AUD at 6 months, which further linked to less improvement in depression symptoms in the 6-18 months time window. Conclusions Longitudinal and individual-level courses of both internalizing and externalizing disorders in adult patients with MDD seem to be dependent, albeit to differing degrees, on the course of depressive symptoms.
引用
收藏
页码:949 / 959
页数:11
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