Clinical features of patients with dysthymia in a large cohort of Han Chinese women with recurrent major depression.
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Wu Wenqing, Wang Zhoubing, Wei Yan, Zhang Guanghua, Shi Shenxun, Gao Jingfang, Li Youhui, Tao Ming, Zhang Kerang, Wang Xumei, Gao Chengge, Yang Lijun, Li Kan, Shi Jianguo, Wang Gang, Liu Lanfen, Zhang Jinbei, Du Bo, Jiang Guoqing, Shen Jianhua, Liu Ying, Liang Wei, Sun Jing, Hu Jian, Liu Tiebang, Wang Xueyi, Miao Guodong, Meng Huaqing, Li Yi, Hu Chunmei, Li Yi, Huang Guoping, Li Gongying, Ha Baowei, Deng Hong, Mei Qiyi, Zhong Hui, Gao Shugui, Sang Hong, Zhang Yutang, Fang Xiang, Yu Fengyu, Yang Donglin, Liu Tieqiao, Chen Yunchun, Hong Xiaohong, Wu Wenyuan, Chen Guibing, Cai Min, Song Yan, Pan Jiyang, Dong Jicheng, Pan Runde, Zhang Wei, Shen Zhenming, Liu Zhengrong, Gu Danhua, Wang Xiaoping, Liu Xiaojuan, Zhang Qiwen, Li Yihan, Chen Yiping, Kendler Kenneth S, Flint Jonathan, Zhang Zhen
Аннотация
RESULTS: We examined the clinical features in 5,950 Han Chinese women with MDD between 30-60 years of age across China. We confirmed earlier results by replicating prior analyses in 3,950 new MDD cases. There were no significant differences between the two data sets. We identified sixteen stressful life events that significantly increase the risk of dysthymia, given the presence of MDD. Low parental warmth, from either mother or father, increases the risk of dysthymia. Highly threatening but short-lived threats (such as rape) are more specific for MDD than dysthymia. While for MDD more severe life events show the largest odds ratio versus controls, this was not seen for cases of MDD with or without dysthymia.
CONCLUSIONS: There are increased rates of stressful life events in MDD with dysthymia, but the impact of life events on susceptibility to dysthymia with MDD differs from that seen for MDD alone. The pattern does not fit a simple dose-response relationship, suggesting that there are moderating factors involved in the relationship between environmental precipitants and the onset of dysthymia. It is possible that severe life events in childhood events index a general susceptibility to chronic depression, rather than acting specifically as risk factors for dysthymia.