摘要
目的调查抑郁症共病广泛性焦虑障碍(general anxiety disorder,GAD)的流行情况并探索潜在的发病风险因素。方法本研究为多中心、横断面研究,共纳入国内9家中心的1086例抑郁症患者。采用MINI诊断抑郁症和GAD,使用生活事件量表(Life Events Scale,LES)和儿童期虐待问卷(Childhood Trauma Questionnaire,CTQ)分别评估生活应激水平和童年期虐待。采用17项汉密尔顿抑郁量表(Hamilton Depression Rating Scale-17 item,HAMD17)、社会支持评定量表(Social Support Rate Scale,SSRS)、简易应对方式问卷(Simplified Coping Style Questionnaire,SCSQ)以及艾森克人格问卷简式量表中文版(Eysenck Personality Questionnaire,short scale for China,EPQ-RSC)评估患者的抑郁症状严重程度、社会支持、应对方式和人格特点。使用Pearson相关分析、单因素回归分析和多因素Logistic回归分析探索临床特征、生活应激和社会心理因素与抑郁症共病GAD的关系。结果1086例抑郁症患者中,276例(25.4%)共病GAD(共病GAD组),810例(74.6%)不共病GAD(不共病GAD组)。共病GAD组的患者存在成年期应激的比例高于不共病GAD组[60.2%(165/276)与39.9%(321/810),χ^2=33.993,P<0.01],2组在社会支持、应对方式方面差异无统计学意义,而共病GAD组患者的神经质水平更高、外向性水平更低。Logistic回归校正混杂因素后显示,成年期应激(OR=1.720,95%CI 1.262~2.343,P<0.01)和高神经质水平(OR=1.211,95%CI 1.141~1.286,P<0.01)与抑郁症共病GAD有关。结论成年期应激和神经质水平高可能是抑郁症共病GAD的潜在风险因素,这为抑郁症患者亚群进行更针对性的干预治疗提供了线索。
Objective This study aimed to examine the prevalence of comorbid generalized anxiety disorder(GAD)among adult patients with major depressive disorder(MDD)in China and explore its potential risk factors.Methods This is a multicenter,cross-sectional study,involving 1086 patients in 9 clinical settings.The diagnosis of MDD and GAD were confirmed by the MINI.Life events were evaluated by the Life Events Scale(LES),and early life stress was assessed by the Childhood Trauma Questionnaire(CTQ).The severity of depression,social support,coping style and personality traits were assessed by Hamilton Depression Rating Scale-17 item(HAMD17),Simplified Coping Style Questionnaire(SCSQ),and Eysenck Personality Questionnaire,short scale for China(EPQ-RSC),respectively.Pearson correlation analysis,univariate regression analysis and Logistic regression analysis were used to explore the association of clinical characteristics,life stress,social factors and comorbidity of MDD and GAD.Results Among 1086 MDD patients,276 of them(25.4%)were diagnosed with comorbid GAD.Patients with comorbid GAD were more likely to report adulthood adversity then those without(60.2%(165/276)vs.39.9%(321/810),χ^2=33.993,P<0.01).However,there was no difference in social support and coping styles between the two groups.Furthermore,patients with comorbid GAD had higher levels of neuroticism,and lower levels of extraversion.After controlling for confounders,logistic regression results showed that adulthood adversity(OR=1.720,95%CI 1.262-2.343,P<0.01)and higher neuroticism levels(OR=1.211,95%CI 1.141-1.286,P<0.01)were significantly associated with comorbid GAD in patients with MDD.Conclusion Adulthood adversity and high levels of neuroticism were potential risk factors of comorbidity of MDD and GAD.This finding provides empirical evidence for developing targeted interventions for this subgroup population with MDD.
作者
林靖宇
苏允爱
吕晓珍
刘琦
王刚
魏镜
朱刚
陈巧灵
田红军
张克让
王学义
张楠
王瑛
于欣
司天梅
Lin Jingyu;Su Yunai;Lyu Xiaozhen;Liu Qi;Wang Gang;Wei Jing;Zhu Gang;Chen Qiaoling;Tian Hongjun;Zhang Kerang;Wang Xueyi;Zhang Nan;Wang Ying;Yu Xin;Si Tianmei(Peking University Sixth Hospital,National Clinical Research Center for Mental Disorders and Key Laboratory of Mental Health,Ministry of Health(Peking University),Beijing 100191,China;Beijing Anding Hospital,Capital Medical University,Beijing 100088,China;Chinese Academy of Medical Sciences&Peking Union Medical College(PUMC),Beijing 100730,China;The First Hospital of China Medical University,Shenyang 110001,China;Dalian Seventh People′s Hospital,Dalian 116023,China;Tianjin Anding Hospital,Tianjin 300074,China;Department of Psychiatry,First Hospital of Shanxi Medical University,Taiyuan 030001,China;The First Hospital of Hebei Medical University,Shijiazhuang 050000,China;Tianjin Medical University General Hospital,Tianjin 300052,China;The 984th Hospital of PLA,Beijing 110108,China)
出处
《中华精神科杂志》
CAS
CSCD
北大核心
2020年第4期287-294,共8页
Chinese Journal of Psychiatry
基金
国家重点基础研究发展计划(973计划)(2013CB531305)
国家科技支撑计划项目(2015BAI13B01)
国家自然科学基金(81630031)
北京市重大科技专项(Z171100000117016)
首都卫生发展科研专项重点攻关项目(2016-1-4111)。
关键词
抑郁症
焦虑
应激
心理学
神经质
横断面研究
Depressive disorder
Anxiety
Stress,psychological
Neuroticism
Cross-sectional studies
