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首页> 外文期刊>The journal of clinical psychiatry >Diurnal mood variation in outpatients with major depressive disorder: implications for DSM-V from an analysis of the sequenced treatment alternatives to relieve depression study data.
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Diurnal mood variation in outpatients with major depressive disorder: implications for DSM-V from an analysis of the sequenced treatment alternatives to relieve depression study data.

机译：重度抑郁症门诊患者的昼夜情绪变化：通过分析缓解抑郁的测序治疗方案对DSM-V的影响。

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OBJECTIVE: Diurnal mood variation (DMV) with early morning worsening is considered a classic symptom of melancholic features in The Diagnostic and Statistical Manual of Mental Disorders (DSM) as well as The International Classification of Diseases (ICD) criteria for somatic major depressive disorder (MDD). Using the unique opportunity afforded by the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study data, we examined whether DMV with afternoon or evening worsening, in addition to classic early morning worsening, was related to other symptom constructs to determine whether the exclusive reliance on morning worsening is justified in defining melancholic features. METHOD: Baseline demographic and clinical characteristics, as well as depressive symptoms, including DMV, were evaluated in 3744 outpatients with nonpsychotic MDD enrolled in the STAR*D study. RESULTS: DMV in at least one of the time periods was reported by 22.4% (N = 837) of the sample. Only 3.3% (N = 28) of these 837 patients with DMV attributed it to environmental factors. Of the 809 participants (96.7%) with DMV unrelated to environmental events, only 31.9% (N = 258) reported morning worsening, while 19.5% (N = 158) and 48.6% (N = 393) reported afternoon and evening worsening, respectively. Minimal distinctions in demographic characteristics, clinical features, and depressive symptoms were found between participants with morning worsening and those with either afternoon or evening worsening. More importantly, other melancholic symptom features were associated with DMV regardless of time of worsening. CONCLUSION: DMV was meaningfully related to other melancholia criteria regardless of when the DMV occurred. If replicated, these findings suggest that DMV as a component of melancholic features might be expanded to include any DMV, not simply early morning worsening.
机译：目的：随着清晨病情的恶化，昼夜情绪变化（DMV）被认为是《精神障碍诊断和统计手册》（DSM）以及《国际疾病分类》（ICD）躯体性重性抑郁症（ICD）标准中忧郁症特征的典型症状（ MDD）。利用缓解抑郁的序贯治疗替代方案（STAR * D）研究数据提供的独特机会，我们检查了除经典清晨恶化外，下午或傍晚恶化的DMV是否与其他症状构造相关，以确定是否排他性定义早晨忧郁症是有理由的。方法：在STAR * D研究中，对3744名非精神病性MDD的门诊患者进行了基线人口统计学和临床​​特征以及包括DMV在内的抑郁症状的评估。结果：在至少一个时间段内，有22.4％（N = 837）的样本报告了DMV。在这837名DMV患者中，只有3.3％（N = 28）归因于环境因素。在与环境事件无关的DMV的809名参与者中（96.7％），仅31.9％（N = 258）报告早晨恶化，而分别有19.5％（N = 158）和48.6％（N = 393）报告下午和晚上恶化。 。早晨恶化的参与者与下午或傍晚恶化的参与者之间的人口统计学特征，临床特征和抑郁症状之间的区别最小。更重要的是，其他忧郁症状特征与DMV相关，而与恶化时间无关。结论：无论何时发生DMV，DMV都与其他忧郁症标准有意义地相关。如果被复制，这些发现表明，作为忧郁症特征的一部分的DMV可能会扩展到包括任何DMV，而不仅仅是早晨恶化。

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