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首页> 外文期刊>The Journal of Nervous and Mental Disease >Is clinical depression distinct from subthreshold depressive symptoms? A review of the continuity issue in depression research.
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Is clinical depression distinct from subthreshold depressive symptoms? A review of the continuity issue in depression research.

机译：临床抑郁症是否与阈下抑郁症状不同？抑郁症研究中的连续性问题综述。

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Resolving whether subthreshold depressive symptoms exist on a continuum with unipolar clinical depression is important for progress on both theoretical and applied issues. To date, most studies have found that individuals with subthreshold depressive symptoms resemble cases of major depressive disorder along many important dimensions (e.g., in terms of patterns of functional impairment, psychiatric and physical comorbidity, familiality, sleeping EEG, and risk of future major depression). However, such manifest similarities do not rule out the possibility of a latent qualitative difference between subthreshold and diagnosable depression. Formal taxonomic analyses, intended to resolve the possibility of a latent qualitative distinction, have so far yielded contradictory findings. Several large-sample latent class analyses (LCA) have identified latent clinical and nonclinical classes of unipolar depression, but LCA is vulnerable to identification of spurious classes. Paul Meehl's taxometric methods provide a potentially conservative alternative way to identify latent classes. The one comprehensive taxometric analysis reported to date suggests that self-report depression symptoms occur along a latent continuum but exclusive reliance on self-report depression measures and incomplete information regarding sample base rates of depression makes it difficult to draw strong inferences from that report. We conclude that although most of the evidence at this time appears to favor both a manifest and latent continuum of unipolar depression symptomatology, several important issues remain unresolved. Complete resolution of the continuity question would be speeded by the application of both taxometric techniques and LCA to a single large sample with a known base rate of lifetime diagnosed depressives.
机译：解决在单极性临床抑郁症连续体中是否存在阈下抑郁症状对于在理论和应用问题上的进展都至关重要。迄今为止，大多数研究发现，具有阈下抑郁症状的人在许多重要方面都与重度抑郁症相似（例如，在功能障碍的模式，精神和身体合并症，家族性，睡眠性脑电图以及未来重度抑郁的风险方面） ）。但是，这种明显的相似性并不排除亚阈值水平与可诊断的抑郁症之间潜在的质量差异的可能性。迄今为止，旨在解决潜在的定性区别的可能性的形式分类学分析迄今得出了矛盾的结论。几种大样本潜在类别分析（LCA）已确定了单相抑郁症的潜在临床和非临床类别，但LCA易于识别虚假类别。保罗·米尔（Paul Meehl）的分类法提供了一种潜在的保守方法来识别潜在类别。迄今报道的一项全面的分类法分析表明，自我报告的抑郁症状沿潜在的连续体出现，但由于完全依赖自我报告的抑郁测量方法，并且关于抑郁症样本基本率的信息不完整，因此很难从该报告中得出有力的推论。我们得出的结论是，尽管目前大多数证据似乎都支持单相抑郁症症状的明显和潜在连续体，但仍有一些重要问题尚未解决。通过将分类法技术和LCA应用于具有已知的终生诊断抑郁症基本比率的单个大样本，可以加快连续性问题的完全解决。

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