Department of Neuropsychiatry, Hirosaki University School of Medicine, Hirosaki, Aomori, Japan.
J Affect Disord. 2012 Dec 15;142(1-3):264-8. doi: 10.1016/j.jad.2012.05.011. Epub 2012 Jul 24.
In Japan, the annual number of deaths by suicide markedly increased in 1998 and leveled off at approximately 30,000 per year thereafter. The coping behaviors used to deal with stress may have implications for the prevention of depression and suicidal ideation. This study examined coping behaviors in relation to depression and suicidal ideation.
In this cross-sectional study, a total of 6762 workers (40-60 years of age; 4119 males and 2643 females) completed both the Center for Epidemiologic Studies Depression scale (CES-D) and a questionnaire measuring suicidal ideation. A cut-off score of 19 was used to define probable depression for the CES-D. Stress-coping behaviors were surveyed via an inventory of 14 items that reflected of actual behaviors covering problem-focused, emotion-focused, and avoidant strategies.
In relation to depression, logistic regression analyses revealed that in both genders, the highest odds ratios (OR) for avoidant coping strategy and the lowest OR was associated with a problem-focused strategy after adjusting for covariates. After making the same adjustments, logistic regression analyses revealed that in both genders, the highest OR were for emotional distraction coping strategies in relation to suicidal ideation.
The cross-sectional nature of this study does not allow for causal assumptions regarding the sequential nature of the relationship between coping behaviors and the onset of depressive symptoms or suicidal ideation.
These findings indicate that coping behaviors may affect both depressive symptoms and suicidal ideation. Furthermore, gender differences in coping behaviors among middle-aged workers were identified. Additional studies are needed to examine the relationships among coping behaviors, depression and suicidal ideation using a longitudinal design.
在日本，1998 年自杀死亡人数明显增加，此后每年稳定在约 30000 人。应对压力的应对行为可能对预防抑郁和自杀意念有影响。本研究探讨了与抑郁和自杀意念相关的应对行为。
在这项横断面研究中，共有 6762 名工人（40-60 岁；4119 名男性和 2643 名女性）完成了流行病学研究抑郁量表（CES-D）和自杀意念问卷。CES-D 的截值分数为 19，用于定义可能的抑郁。通过 14 项反映实际行为的应对策略的清单来调查压力应对行为，这些行为涵盖了问题聚焦、情绪聚焦和回避策略。
与抑郁相关，逻辑回归分析显示，在两性中，回避应对策略的最高优势比（OR）和最低 OR 与问题聚焦策略相关，在调整协变量后。在进行相同调整后，逻辑回归分析显示，在两性中，与自杀意念相关的最高 OR 是情绪分散应对策略。
这项研究的横断面性质不允许对应对行为与抑郁症状或自杀意念发作之间的顺序关系做出因果假设。
这些发现表明应对行为可能会影响抑郁症状和自杀意念。此外，还确定了中年工人中应对行为的性别差异。需要进一步的研究使用纵向设计来检验应对行为、抑郁和自杀意念之间的关系。
