Department of Psychiatry, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Psychol Med. 2011 Jul;41(7):1419-28. doi: 10.1017/S0033291710002151. Epub 2010 Dec 10.
Depression increases the risk of subsequent vascular events in both cardiac and non-cardiac patients. Atherosclerosis, the underlying process leading to vascular events, has been associated with depression. This association, however, may be confounded by the somatic-affective symptoms being a consequence of cardiovascular disease. While taking into account the differentiation between somatic-affective and cognitive-affective symptoms of depression, we examined the association between depression and atherosclerosis in a community-based sample.
In 1261 participants of the Nijmegen Biomedical Study (NBS), aged 50-70 years and free of stroke and dementia, we measured the intima-media thickness (IMT) of the carotid artery as a measure of atherosclerosis and we assessed depressive symptoms using the Beck Depression Inventory (BDI). Principal components analysis (PCA) of the BDI items yielded two factors, representing a cognitive-affective and a somatic-affective symptom cluster. While correcting for confounders, we used separate multiple regression analyses to test the BDI sum score and both depression symptom clusters.
We found a significant correlation between the BDI sum score and the IMT. Cognitive-affective, but not somatic-affective, symptoms were also associated with the IMT. When we stratified for coronary artery disease (CAD), the somatic-affective symptom cluster correlated significantly with depression in both patients with and patients without CAD.
The association between depressive symptoms and atherosclerosis is explained by the somatic-affective symptom cluster of depression. Subclinical vascular disease thus may inflate depressive symptom scores and may explain why treatment of depression in cardiac patients hardly affects vascular outcome.
抑郁症增加了心脏和非心脏患者后续发生血管事件的风险。动脉粥样硬化是导致血管事件的潜在过程，与抑郁症有关。然而，这种关联可能会因躯体情感症状是心血管疾病的后果而受到混淆。在考虑到躯体情感和认知情感抑郁症状的区别的情况下，我们在一个基于社区的样本中研究了抑郁症与动脉粥样硬化之间的关系。
在年龄在 50-70 岁、没有中风和痴呆的 1261 名奈梅亨生物医学研究（NBS）参与者中，我们测量了颈动脉的内-中膜厚度（IMT）作为动脉粥样硬化的衡量指标，并使用贝克抑郁量表（BDI）评估了抑郁症状。BDI 项目的主成分分析（PCA）得出了两个因子，代表认知情感和躯体情感症状群。在纠正混杂因素后，我们使用单独的多元回归分析来测试 BDI 总分和两个抑郁症状群。
我们发现 BDI 总分与 IMT 之间存在显著相关性。认知情感，而不是躯体情感，症状也与 IMT 相关。当我们对冠状动脉疾病（CAD）进行分层时，躯体情感症状群在 CAD 患者和无 CAD 患者中均与抑郁显著相关。
抑郁症状与动脉粥样硬化之间的关联可以用抑郁的躯体情感症状群来解释。亚临床血管疾病可能会使抑郁症状评分升高，并解释为什么治疗心脏患者的抑郁对血管预后几乎没有影响。
