Introduction: Appraisal of prodromal symptoms of unipolar depression may complement the traditional cross-sectional approach and provide a longitudinal perspective, according to a staging model of the illness. Objective: To provide an updated systematic review of clinical studies concerned with prodromal symptoms of unipolar depression, according to PRISMA guidelines. Methods: Keyword searches were conducted in PubMed, Scopus, and Web of Science. Longitudinal studies on prodromal symptoms and signs in adult patients primarily diagnosed with unipolar depression were selected. Findings were examined separately according to study design (i.e., retrospective or prospective). Results: Twenty-five studies met the criteria for inclusion in this systematic review. Findings indicate that a distinct prodromal symptomatology – commonly characterized by anxiety, tension, irritability, and somatic complaints – exists before the onset of unipolar depression. The duration of the prodromal phase was highly variable across studies, ranging from less than a month to several years. Prodromal symptoms profile and duration were consistent within individuals across depressive episodes. There was a close relationship between prodromal and residual symptoms of the same depressive episode. Conclusions: The present systematic review addresses an important, and yet relatively neglected, clinical issue that deserves further investigation and may be of immediate practical value. The findings provide challenging insights into the pathogenesis and course of unipolar depression, which may result in more timely and effective treatment of recurrences. The definition of a prodromal phase in depression would benefit from the joint use of symptom identification, biomarkers, and neuroimaging.
Psychother Psychosom

中文翻译：

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抑郁症的前驱症状：系统评价

简介：根据疾病的分期模型，评估单相抑郁的前驱症状可以补充传统的横断面方法并提供纵向视角。目的：根据 PRISMA 指南，对有关单相抑郁前驱症状的临床研究进行更新的系统评价。方法：在 PubMed、Scopus 和 Web of Science 中进行关键词搜索。选择了对主要诊断为单相抑郁的成年患者的前驱症状和体征进行的纵向研究。根据研究设计（即回顾性或前瞻性）分别检查结果。结果：25 项研究符合纳入本系统评价的标准。研究结果表明，在单相抑郁症发作之前存在明显的前驱症状——通常以焦虑、紧张、易怒和躯体不适为特征。前驱期的持续时间因研究而异，从不到一个月到几年不等。在抑郁发作期间，前驱症状特征和持续时间在个体中是一致的。同一抑郁发作的前驱症状和残留症状之间存在密切关系。结论：本系统评价解决了一个重要但相对被忽视的临床问题，值得进一步研究，可能具有直接的实用价值。这些发现为单相抑郁症的发病机制和病程提供了具有挑战性的见解，这可能会导致更及时和有效的复发治疗。抑郁症前驱期的定义将受益于症状识别、生物标志物和神经影像学的联合使用。
心理治疗师