Alpert Medical School of Brown University, Center for Primary Care and Prevention, Memorial Hospital of Rhode Island and Brown University, 111 Brewster Street, Pawtucket, RI, 02860, USA,
Soc Psychiatry Psychiatr Epidemiol. 2013 Dec;48(12):1971-82. doi: 10.1007/s00127-013-0693-z. Epub 2013 May 5.
To determine whether social support and/or physical activity buffer the association between stressors and increasing risk of depression symptoms at baseline and at 3-year follow-up.
This is a secondary analysis of data from the Women's Health Initiative Observational Study. 91,912 community-dwelling post-menopausal women participated in this prospective cohort study. Depression symptoms were measured at baseline and 3 years later; social support, physical activity, and stressors were measured at baseline.
Stressors at baseline, including verbal abuse, physical abuse, caregiving, social strain, negative life events, financial stress, low income, acute pain, and a greater number of chronic medical conditions, were all associated with higher levels of depression symptoms at baseline and new onset elevated symptoms at 3-year follow-up. Social support and physical activity were associated with lower levels of depressive symptoms. Contrary to expectation, more social support at baseline strengthened the association between concurrent depression and physical abuse, social strain, caregiving, and low income. Similarly, more social support at baseline increased the association between financial stress, income, and pain on new onset depression 3 years later. Physical activity similarly moderated the effect of caregiving, income, and pain on depression symptoms at baseline.
Stressors, social support, and physical activity showed predicted main effect associations with depression. Multiplicative interactions were small in magnitude and in the opposite direction of what was expected.
确定社会支持和/或体力活动是否缓冲了压力源与基线和 3 年随访时抑郁症状增加风险之间的关联。
这是对妇女健康倡议观察性研究数据的二次分析。91912 名居住在社区的绝经后妇女参与了这项前瞻性队列研究。在基线和 3 年后测量抑郁症状；在基线时测量社会支持、体力活动和压力源。
基线时的压力源，包括言语虐待、身体虐待、照顾、社会紧张、负面生活事件、经济压力、低收入、急性疼痛和更多的慢性疾病，都与基线时更高水平的抑郁症状和 3 年后新出现的升高症状相关。社会支持和体力活动与较低水平的抑郁症状相关。与预期相反，基线时更多的社会支持加强了当前抑郁与身体虐待、社会紧张、照顾和低收入之间的关联。同样，基线时更多的社会支持增加了 3 年后财务压力、收入和疼痛与新发抑郁之间的关联。体力活动也同样调节了照顾、收入和疼痛对基线时抑郁症状的影响。
压力源、社会支持和体力活动与抑郁呈预测性的主要效应关联。乘法交互作用的幅度较小，且与预期的方向相反。
