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抑郁症患者的应对行为:一项纵向研究。

Coping behavior in depressed patients: a longitudinal study.

作者信息

Yamada Kumiko, Nagayama Haruo, Tsutiyama Kounosuke, Kitamura Tosinori, Furukawa Toshiaki

机构信息

Department of Neuropsychiatry, Oita Medical University, Idaigaoka 1-1, Hasamamatchi, Oita gun, Oita 879-5503, Japan.

出版信息

Psychiatry Res. 2003 Dec 1;121(2):169-77. doi: 10.1016/s0165-1781(03)00249-x.

Abstract

The relationship of coping behavior to outcome in depressed patients was examined. Subjects (n=105) with major depressive disorder (n=85), depressive disorder not otherwise specified (n=7) or major depressive disorder with axis I comorbidity (n=13) were followed for 6 months. Their coping behavior (i.e. rumination, active distraction, cognitive distraction and dangerous activities) was defined using the Comprehensive Assessment List for Affective Disorders. Based on their Hamilton Rating Scale for Depression (HRSD) scores at 6 months, the patients were categorized as having had a good or a poor outcome. Severity of depression and coping behavior were similar among the three diagnostic groups. At baseline assessment, coping behavior was not correlated with either HRSD score or age. However, males were significantly more likely to be engaged in dangerous activity as a coping behavior than females. Patients with a good outcome at 6 months were significantly more likely to use rumination as a coping behavior while patients with a poor outcome were significantly more likely to use dangerous activity. Multiple regression analysis confirmed this finding, indicating that rumination and dangerous activity were significant predictors of outcome at 6 months. Rumination might be associated with good outcomes in depressed patients while dangerous activity might be associated with poor outcomes.

摘要

研究了抑郁症患者应对行为与治疗结果之间的关系。对患有重度抑郁症(85例)、未另行规定的抑郁症(7例)或伴有I轴共病的重度抑郁症(13例)的受试者(n = 105)进行了为期6个月的随访。使用情感障碍综合评估清单来定义他们的应对行为(即沉思、积极分心、认知分心和危险行为)。根据他们6个月时的汉密尔顿抑郁量表(HRSD)评分,将患者分为预后良好或不良。三个诊断组之间的抑郁严重程度和应对行为相似。在基线评估时,应对行为与HRSD评分或年龄均无相关性。然而,作为一种应对行为,男性从事危险行为的可能性显著高于女性。6个月时预后良好的患者使用沉思作为应对行为的可能性显著更高,而预后不良的患者使用危险行为的可能性显著更高。多元回归分析证实了这一发现,表明沉思和危险行为是6个月时治疗结果的显著预测因素。沉思可能与抑郁症患者的良好预后相关,而危险行为可能与不良预后相关。

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