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PLoS One. 2013 Dec 27;8(12):e83490. doi: 10.1371/journal.pone.0083490. eCollection 2013.

Clinical features of patients with dysthymia in a large cohort of Han Chinese women with recurrent major depression.

Wu W1, Wang Z1, Wei Y1, Zhang G1, Shi S2, Gao J3, Li Y4, Tao M5, Zhang K6, Wang X7, Gao C8, Yang L9, Li K10, Shi J11, Wang G12, Liu L13, Zhang J14, Du B15, Jiang G16, Shen J17, Liu Y18, Liang W19, Sun J20, Hu J21, Liu T22, Wang X23, Miao G24, Meng H25, Li Y26, Hu C27, Li Y28, Huang G29, Li G30, Ha B31, Deng H32, Mei Q33, Zhong H34, Gao S35, Sang H36, Zhang Y37, Fang X38, Yu F39, Yang D40, Liu T41, Chen Y42, Hong X43, Wu W44, Chen G45, Cai M46, Song Y47, Pan J48, Dong J49, Pan R50, Zhang W51, Shen Z52, Liu Z53, Gu D54, Wang X55, Liu X56, Zhang Q57, Li Y58, Chen Y59, Kendler KS60, Flint J58, Zhang Z1.

Author information

1
No. 4 Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, P.R. China.
2
Shanghai Mental Health Center, Shanghai, P.R. China ; Huashan Hospital of Fudan University, Shanghai, P.R. China.
3
Chinese Traditional Hospital of Zhejiang, Hangzhou, Zhejiang, P.R. China.
4
No. 1 Hospital of Zhengzhou University, Zhengzhou, Henan, P.R. China.
5
Xinhua Hospital of Zhejiang Province, Hangzhou, Zhejiang, P.R. China.
6
No. 1 Hospital of Shanxi Medical University, Taiyuan, Shanxi, P.R. China.
7
ShengJing Hospital of China Medical University, Heping District, Shenyang, Liaoning, P.R. China.
8
No. 1 Hospital of Medical College of Xian Jiaotong University, Xian, Shaanxi, P.R. China.
9
Jilin Brain Hospital, Siping, Jilin, P.R. China.
10
Mental Hospital of Jiangxi Province, Nanchang, Jiangxi, P.R. China.
11
Xian Mental Health Center, New Qujiang District, Xian, Shaanxi, P.R. China.
12
Beijing Anding Hospital of Capital University of Medical Sciences, Deshengmen wai, Xicheng District, Beijing, P.R. China.
13
Shandong Mental Health Center, Jinan, Shandong, P.R. China.
14
No. 3 Hospital of Sun Yat-sen University, Tianhe District, Guangzhou, Guangdong, P.R. China.
15
Hebei Mental Health Center, Baoding, Hebei, P.R. China.
16
Chongqing Mental Health Center, Jiangbei District, Chongqing, P.R. China.
17
Tianjin Anding Hospital, Hexi District, Tianjin, P.R. China.
18
The First Hospital of China Medical University, Heping District, Shenyang, Liaoning, P.R. China.
19
Psychiatric Hospital of Henan Province, Xinxiang, Henan, P.R. China.
20
Nanjing Brain Hospital, Nanjing, Jiangsu, P.R. China.
21
Harbin Medical University, Nangang District, Haerbin, Heilongjiang, P.R. China.
22
Shenzhen Kang Ning Hospital, Luohu District, Shenzhen, Guangdong, P.R. China.
23
First Hospital of Hebei Medical University, Shijiazhuang, Hebei, P.R. China.
24
Guangzhou Brain Hospital (Guangzhou Psychiatric Hospital), Liwan District, Guangzhou, Guangdong, P.R. China.
25
No. 1 Hospital of Chongqing Medical University, Yuanjiagang,Yuzhong District, Chongqing, P.R. China.
26
Dalian No. 7 Hospital, Ganjingzi District, Dalian, Liaoning, P.R. China.
27
No. 3 Hospital of Heilongjiang Province, Beian, Heilongjiang, P.R. China.
28
Wuhan Mental Health Center, Wuhan, Hubei, P.R. China.
29
Sichuan Mental Health Center, Mianyang, Sichuan, P.R. China.
30
Mental Health Institute of Jining Medical College, Dai Zhuang, Bei Jiao, Jining, Shandong, P.R. China.
31
Liaocheng No. 4 Hospital, Liaocheng, Shandong, P.R. China.
32
Mental Health Center of West China Hospital of Sichuan University, Wuhou District, Chengdu, Sichuan, P.R. China.
33
Suzhou Guangji Hospital, Suzhou, Jiangsu, P.R. China.
34
Anhui Mental Health Center, Hefei, Anhui, P.R. China.
35
Ningbo Kang Ning Hospital, Zhenhai District, Ningbo, Zhejiang, P.R. China.
36
Changchun Mental Hospital, Changchun, Jilin, P.R. China.
37
No. 2 Hospital of Lanzhou University, Lanzhou, Gansu, P.R. China.
38
Fuzhou Psychiatric Hospital, Cangshan District, Fuzhou, Fujian, P.R. China.
39
Harbin No. 1 Special Hospital, Haerbin, Heilongjiang, P.R. China.
40
Jining Psychiatric Hospital, North Dai Zhuang, Rencheng District, Jining, Shandong, P.R. China.
41
No. 2 Xiangya Hospital of Zhongnan University, Furong District, Changsha, Hunan, P.R. China.
42
Xijing Hospital of No. 4 Military Medical University, Xian, Shaanxi, P.R. China.
43
Mental Health Center of Shantou University, Shantou, Guangdong, P.R. China.
44
Tongji University Hospital, Shanghai, P.R. China.
45
Huaian No. 3 Hospital, Huaian, Jiangsu, P.R. China.
46
Huzhou No. 3 Hospital, Huzhou, Zhejiang, P.R. China.
47
Mudanjiang Psychiatric Hospital of Heilongjiang Province, Xinglong, Mudanjiang, Heilongjiang, P.R. China.
48
No. 1 Hospital of Jinan University, Guangzhou, Guangdong, P.R. China.
49
Qingdao Mental Health Center, Shibei District, Qingdao, Shandong, P.R. China.
50
Guangxi Longquanshan Hospital, Yufeng District, Liuzhou, P.R. China.
51
Daqing No. 3 Hospital of Heilongjiang Province, Ranghulu District, Daqing, Heilongjiang, P.R. China.
52
Tangshan No. 5 Hospital, Lunan District, Tangshan, Hebei, P.R. China.
53
Anshan Psychiatric Rehabilitation Hospital, Lishan District, Anshan, Liaoning, P.R. China.
54
Weihai Mental Health Center, Qilu Avenue, ETDZ, Weihai, Shandong, P.R. China.
55
Renmin Hospital of Wuhan University, Wuchang District, Wuhan, Hubei, P.R. China.
56
Tianjin First Center Hospital, Hedong District, Tianjin, P.R. China.
57
Hainan Anning Hospital, Haikou, Hainan, P.R. China.
58
Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom.
59
Clinical Trial Service Unit, Richard Doll Building, Oxford, United Kingdom.
60
Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia, United States of America.

Abstract

BACKGROUND:

Dysthymia 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.

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.

PMID:
24386213
PMCID:
PMC3873934
DOI:
10.1371/journal.pone.0083490
[Indexed for MEDLINE]
Free PMC Article
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