Interdisciplinary Center of Psychiatric Epidemiology, Department of Psychiatry, University Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB Groningen, the Netherlands.
Psychosom Med. 2012 Jun;74(5):446-51. doi: 10.1097/PSY.0b013e31825a7194.
To test whether vital exhaustion overlaps more with somatic/affective depression than with cognitive/affective depressive symptoms and evaluate the risk of recurrent cardiovascular events associated with these constructs.
The Beck Depression Inventory (BDI) and the Maastricht Questionnaire (MQ) were administered to 528 patients hospitalized with myocardial infarction (MI). Principal component analyses (PCAs) were performed to assess the structure of the BDI, the MQ, and both combined. Univariate and multivariate (adjusting for age, sex, left ventricular ejection fraction, Killip Class, and history of MI) Cox proportional hazard regression analyses were used to examine the risk of recurrent cardiovascular events associated with the subscales of the MQ and of both questionnaires together.
PCA on the MQ yielded only one dimension. Per-standard-deviation increase in total MQ score, the multivariate hazard ratio was 1.37 (confidence interval [CI] = 1.15-1.64, p < .001). PCA on the items of MQ and BDI together yielded two dimensions: a somatic/affective and a cognitive/affective dimension. All but two of the items of the MQ loaded on the somatic/affective dimension. The multivariate hazard ratio for recurrent events associated with a 1-standard deviation increase in the somatic/affective dimension was 1.39 (CI = 1.11-1.73, p = .004), which was higher than the risk associated with the cognitive/affective dimension (1.02, CI = 0.82-1.27, p = .83).
Vital exhaustion and somatic/affective depression strongly overlap and may cover the same underlying construct that increased the risk of new cardiovascular events.
检验衰竭是否比认知/情感抑郁更与躯体/情感抑郁重叠，并评估与这些结构相关的复发性心血管事件的风险。
对 528 名因心肌梗死（MI）住院的患者进行贝克抑郁量表（BDI）和马斯特里赫特问卷（MQ）的测试。进行主成分分析（PCA）以评估 BDI、MQ 以及两者的综合结构。采用单变量和多变量（调整年龄、性别、左心室射血分数、Killip 分级和 MI 病史）Cox 比例风险回归分析来检验与 MQ 子量表以及两个问卷总分相关的复发性心血管事件的风险。
MQ 的 PCA 仅产生一个维度。MQ 总分每增加一个标准差，多变量危险比为 1.37（置信区间 [CI] = 1.15-1.64，p <.001）。MQ 和 BDI 项目的 PCA 产生了两个维度：躯体/情感和认知/情感维度。MQ 的除了两个项目外的所有项目都加载在躯体/情感维度上。与躯体/情感维度增加一个标准差相关的复发性事件的多变量危险比为 1.39（CI = 1.11-1.73，p =.004），这高于与认知/情感维度相关的风险（1.02，CI = 0.82-1.27，p =.83）。
衰竭和躯体/情感抑郁有很强的重叠，可能涵盖了增加新的心血管事件风险的相同潜在结构。
