A systematic review of the mortality of depression

被引:507
作者
Wulsin, LR
Vaillant, GE
Wells, VE
机构
[1] Univ Cincinnati, Dept Psychiat, Cincinnati, OH 45267 USA
[2] Harvard Univ, Brigham & Womens Hosp, Sch Med, Boston, MA 02115 USA
[3] Univ Cincinnati, Inst Hlth Policy & Hlth Serv Res, Cincinnati, OH 45267 USA
来源
PSYCHOSOMATIC MEDICINE | 1999年 / 61卷 / 01期
关键词
depression; affective disorders; death; mortality;
D O I
10.1097/00006842-199901000-00003
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Objective:The literature on the mortality of depression was assessed with respect to five issues: 1) strength of evidence for increased mortality, 2) controlling for mediating factors, 3) the contribution of suicide, 4) variation across sample types, and 5) possible mechanisms. Method: All relevant English language databases from 1966 to 1996 were searched for reviews and studies that included 1) a formal assessment of depressive symptoms or disorders, 2) death rates or risks, and 3) an appropriate comparison group. Results: There were 57 studies found; 29 (51%) were positive, 13 (23%) negative, and 15 (26%) mixed. Twenty-one studies (37%) ranked among the better studies on the strength of evidence scale used in this study, but there are too few comparable, well-controlled studies to provide a sound estimate of the mortality risk associated with depression. Only six studios controlled for more than one of the four major mediating factors. Suicide accounted for less than 20% of the deaths in psychiatric samples, and less than 1% in medical and community samples. Depression seems to increase the risk of death by cardiovascular disease, especially in men, but depression does not seem to increase the risk of death by cancer. Variability in methods prevents a more rigorous meta-analysis of risk. Conclusion: The studies linking depression to early death are poorly controlled, but they suggest that depression substantially increases the risk of death, especially death by unnatural causes and cardiovascular disease. Future well-controlled studies of high risk groups may guide efforts to develop treatments that reduce the mortality risk of depression.
引用
收藏
页码:6 / 17
页数:12
相关论文
共 71 条
  • [1] BIOBEHAVIORAL VARIABLES AND MORTALITY OR CARDIAC-ARREST IN THE CARDIAC-ARRHYTHMIA PILOT-STUDY (CAPS)
    AHERN, DK
    GORKIN, L
    ANDERSON, JL
    TIERNEY, C
    HALLSTROM, A
    EWART, C
    CAPONE, RJ
    SCHRON, E
    KORNFELD, D
    HERD, JA
    RICHARDSON, DW
    FOLLICK, MJ
    [J]. AMERICAN JOURNAL OF CARDIOLOGY, 1990, 66 (01) : 59 - 62
  • [2] DEPRESSED AFFECT, HOPELESSNESS, AND THE RISK OF ISCHEMIC-HEART-DISEASE IN A COHORT OF UNITED-STATES ADULTS
    ANDA, R
    WILLIAMSON, D
    JONES, D
    MACERA, C
    EAKER, E
    GLASSMAN, A
    MARKS, J
    [J]. EPIDEMIOLOGY, 1993, 4 (04) : 285 - 293
  • [3] DEPRESSION AND CARDIOVASCULAR-DISEASES
    AROMAA, A
    RAITASALO, R
    REUNANEN, A
    IMPIVAARA, O
    HELIOVAARA, M
    KNEKT, P
    LEHTINEN, V
    JOUKAMAA, M
    MAATELA, J
    [J]. ACTA PSYCHIATRICA SCANDINAVICA, 1994, 89 : 77 - 82
  • [4] AVERY D, 1976, ARCH GEN PSYCHIAT, V33, P1029
  • [5] MORTALITY EXPERIENCE OF A POPULATION WITH PSYCHIATRIC ILLNESS
    BABIGIAN, HM
    ODOROFF, CL
    [J]. AMERICAN JOURNAL OF PSYCHIATRY, 1969, 126 (04) : 470 - &
  • [6] Depression and long-term mortality risk in patients with coronary artery disease
    Barefoot, JC
    Helms, MJ
    Mark, DB
    Blumenthal, JA
    Califf, RM
    Haney, TL
    OConnor, CM
    Siegler, IC
    Williams, RB
    [J]. AMERICAN JOURNAL OF CARDIOLOGY, 1996, 78 (06) : 613 - 617
  • [7] Symptoms of depression, acute myocardial infarction, and total mortality in a community sample
    Barefoot, JC
    Schroll, M
    [J]. CIRCULATION, 1996, 93 (11) : 1976 - 1980
  • [8] MORTALITY IN SEVERE DEPRESSION - A PROSPECTIVE-STUDY INCLUDING 103 SUICIDES
    BERGLUND, M
    NILSSON, K
    [J]. ACTA PSYCHIATRICA SCANDINAVICA, 1987, 76 (04) : 372 - 380
  • [9] BLACK D, 1985, ARCHIT DIGEST, V42, P82
  • [10] IS DEATH FROM NATURAL CAUSES STILL EXCESSIVE IN PSYCHIATRIC-PATIENTS - A FOLLOW-UP OF 1593 PATIENTS WITH MAJOR AFFECTIVE-DISORDER
    BLACK, DW
    WINOKUR, G
    NASRALLAH, A
    [J]. JOURNAL OF NERVOUS AND MENTAL DISEASE, 1987, 175 (11) : 674 - 680