A comparison of the clinical characteristics of Chinese patients with recurrent major depressive disorder with and without dysthymia

Sang, Wenhua; Li, Y; Su, Liang; Yang, Fuzhong; Wu, Wei; Shang, Xiaofang; Zhang, G; Shen, Jianhua; Sun, Mengmeng; Guo, Liang; Li, Z; Yan, Lijuan; Zhang, B; Wang, G; Liu, G; Liu, T; Zhang, J; Wang, Y; Yu, Bin; Pan, Jiyang; Hu, Chen; Yang, Lijun; Huang, Yueqin; Xie, Shuang; Wang, X; Liu, J; Lv, Luxian; Chen, Y; Zhang, L; Dang, Yanan; Shi, Sheng; Kendler, Kenneth S.; Flint, Jonathan; Li, K

doi:10.1016/j.jad.2011.06.051

Cited by 15 publications

(14 citation statements)

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“…This study, initiated in 2008, has now obtained detailed clinical characteristics and information on known risk factors for MDD in 5,950 cases of recurrent MDD. An initial study published in 2011, reported results from 2,000 cases of recurrent MDD [22]. Here we extend our observations to explore the nature of the relationship between dysthymia and sensitivity to the environment.…”

Section: Introductionsupporting

confidence: 67%

Clinical Features of Patients with Dysthymia in a Large Cohort of Han Chinese Women with Recurrent Major Depression

Wang

Yan

et al. 2013

PLoS ONE

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BackgroundDysthymia is a form of chronic mild depression that has a complex relationship with major depressive disorder (MDD). Here we investigate the role of environmental risk factors, including stressful life events and parenting style, in patients with both MDD and dysthymia. We ask whether these risk factors act in the same way in MDD with and without dysthymia.ResultsWe 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.ConclusionsThere 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.

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Section: Introductionsupporting

confidence: 67%

Clinical Features of Patients with Dysthymia in a Large Cohort of Han Chinese Women with Recurrent Major Depression

Wang

Yan

et al. 2013

PLoS ONE

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“…Although studies have defined the groups in a variety of ways (e.g., chronicity has been defined as a duration of 1 year or 2 years; non-chronic depression has been limited to major depression or also included minor depression), the results have been fairly consistent. Compared to non-chronic depression, chronic depression is characterized by higher rates of comorbid anxiety (Angst, Gamma, Rössler, Ajdacic, & Klein, 2009; Murphy & Byrne, 2012; Sang et al, 2011; Shankman et al, 2004) and personality disorders (Garyfallos et al, 1999; Markowitz et al, 1992; Pepper et al, 1995), higher levels of depressotypic cognitions (Blanco et al, 2010; Riso et al, 2003), greater suicidality (Gilmer et al, 2005; Holm-Denoma, Berlim, Fleck, & Joiner, 2006; Klein et al, 2006), and more childhood adversity and maltreatment (Angst, Gamma, Rössler, Ajdacic, & Klein, 2011; Horwitz, Widom, McLaughlin, & White, 2001; Lizardi et al, 1995; Wiersma et al, 2009). In addition, chronic depression aggregates in families of probands with chronic, but not non-chronic, depression (Klein et al, 1995, 2004; Mondimore et al, 2006) and the distinction between chronic and episodic depression is stable over time (Klein, Shankman & Rose, 2006).…”

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confidence: 99%

Course of depression in a 10-year prospective study: Evidence for qualitatively distinct subgroups.

Klein¹,

Kotov²

2016

Journal of Abnormal Psychology

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The course of depressive disorders can vary considerable, with some individuals exhibiting a chronic course and poor outcomes, while others have a more episodic course and better outcomes. However it is unclear whether degree of chronicity is continuous or reflects qualitatively distinct subgroups. Using data from a 5-wave, 10-year, naturalistic study of 127 depressed outpatients, we examined whether depression chronicity lies on a continuum or manifests natural boundaries. Spline regression was used to test 7 continuous and discontinuous models of the relationship between depression during the first follow-up interval and multiple outcomes at subsequent follow-ups. In order to further validate the findings, we also created empirically-derived subgroups based on the results of the spline regression analyses and compared them on baseline clinical characteristics and long-term outcomes. There was a clear and consistent discontinuity indicating that for higher levels of chronicity during the first 30 month period, depression was linearly related to outcome; in contrast, for lower levels of chronicity, depression in the initial interval was unrelated to subsequent outcomes. The findings were strikingly consistent across the 4 follow-up evaluations using multiple outcomes and goodness-of-fit indices. In addition, the chronic group--as defined by the first follow-up period--exhibited more baseline chronic depression, anxiety and personality disorders, family history of dysthymia, and childhood adversity, and was more likely to attempt suicide and be hospitalized during follow-up, than the non-chronic group. Results suggest that there are qualitatively distinct classes of patients with more and less chronic depressions, and support the utility of longitudinal course as a means of parsing depression into more homogeneous subgroups.

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“…In non-AA samples, double depression was associated with more comorbid anxiety disorder (Rhebergen et al, 2012; Sang et al, 2011), panic disorder (Sang et al, 2011), various agoraphobias (Sang et al, 2011; Holm-Denoma et al, 2006), and obsessive-compulsive disorder (Holm-Denoma et al, 2006), which may explain the higher rates of disability associated with double depression compared to MDD. However, in the current study, double depression was not associated with more comorbidity, which may explain why AA who endorsed double depression reported similar disability with AA who endorsed MDD.…”

Section: Discussionmentioning

confidence: 99%

“…Compared to MDD, double depression is associated with more disability (Hellerstein et al, 2010). Double depression is also associated with more comorbid anxiety (Rhebergen et al, 2012; Sang et al, 2011), panic (Sang et al, 2011) and obsessive-compulsive disorders (Holm-Denoma et al, 2006), and agoraphobias (Sang et al, 2011; Holm-Denoma et al, 2006) which may explain the higher rates of disability in double depression compared to MDD. Double depression and dysthymia have similar disability and comorbidities (Hellerstein et al, 2010; Rhebergen et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

Disability and comorbidity among major depressive disorder and double depression in African–American adults

Torres

2013

Journal of Affective Disorders

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Background Few studies have examined differences in disability and comorbity among major depressive disorder (MDD), dysthymia, and double depressionin African-Americans (AA). Methods A secondary analysis was performed on AA in the National Survey of American Life. Interviews occurred 2001–2003.A four stage national area probability sampling was performed. DSM-IV-TR diagnoses were obtained witha modified version of the World Health Organization’s expanded version of the Composite International Diagnostic Interview. Disability was measured by interview with the World Health Organization’s Disability Assessment Schedule II. Results Compared to non-depressed AA, AA endorsing MDD (t=19.0, p=.0001) and double depression (t=18.7, p=.0001) reported more global disability; AA endorsing MDD (t=8.5, p=.0063) reported more disability in the Getting Around domain; AA endorsing MDD (t=19.1, p=.0001) and double depression (t=12.1, p=.0014) reported more disability in the Life Activities domain. AA who endorsed double depression reported similar disability and comorbidities with AA who endorsed MDD. Few AA endorsed dysthymia. Limitations This was a cross-sectional study subject to recall bias. The NSAL did not measure minor depression. Conclusions The current study supports the idea of deleting distinct chronic subtypesof depression and consolidating them into a single category termed chronic depression.

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A comparison of the clinical characteristics of Chinese patients with recurrent major depressive disorder with and without dysthymia

Cited by 15 publications

References 17 publications

Clinical Features of Patients with Dysthymia in a Large Cohort of Han Chinese Women with Recurrent Major Depression

Clinical Features of Patients with Dysthymia in a Large Cohort of Han Chinese Women with Recurrent Major Depression

Course of depression in a 10-year prospective study: Evidence for qualitatively distinct subgroups.

Disability and comorbidity among major depressive disorder and double depression in African–American adults

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