Department of Psychiatry, University Medical Center Groningen, Hanzeplein 1, PO Box 30.001, 9700 RB Groningen, The Netherlands.
J Affect Disord. 2013 Oct;151(1):92-9. doi: 10.1016/j.jad.2013.05.057. Epub 2013 Jun 17.
We examined the association of cognitive vulnerability to depression with changes in homogeneous measures of depressive symptoms.
Baseline and 1-year follow-up data were obtained from 2981 participants of the Netherlands study of depression and anxiety. Multivariate regression analyses were carried out on cognitive reactivity, locus of control and implicit and explicit self-depressive associations in combination with negative life events. The purpose of this analysis was to predict changes on the mood/cognition and anxiety/arousal subscales of the inventory of depressive symptomatology - self report.
Cognitive reactivity, locus of control and explicit self-depressive associations were independently associated with changes in depressive symptoms after adjustment for covariates and baseline severity (all p<0.01). Negative life-events interacted with cognitive vulnerability to depression to predict depressive symptoms. Locus of control (b1=0.16, SE=0.02, η(2)=0.01; b2=0.10, SE=0.02, η(2)=0.004, F=8.69, p<0.01) and explicit self-depressive associations (b1=0.10, SE=0.03, η(2)=0.02; b2=0.02, SE=0.04, F=7.50, p<0.01) were more strongly associated with the cognitive (b1) than the somatic (b2) symptom dimension of depression.
The study sample is over-inclusive of depressed patients. Therefore it might be problematic generalizing the findings to the general population.
Cognitive etiological factors may play a role in a "cognitive" subtype of depression. The findings strengthen the notion that homogeneous measures of depressive symptoms enable a greater degree of discrimination between subtypes than a multidimensional conception of depression.
我们研究了抑郁认知易感性与同质抑郁症状变化之间的关系。
从荷兰抑郁和焦虑研究中选取了 2981 名参与者,获得了他们的基线和 1 年随访数据。采用多元回归分析方法,对认知反应性、控制源以及内隐和外显的自我抑郁联想与消极生活事件进行了综合分析。本分析旨在预测心境/认知和焦虑/唤醒分量表的变化,该量表是抑郁症状清单 - 自我报告。
在调整了协变量和基线严重程度后,认知反应性、控制源和外显自我抑郁联想与抑郁症状的变化独立相关(均 p<0.01)。消极生活事件与抑郁认知易感性相互作用,可预测抑郁症状。控制源(b1=0.16,SE=0.02,η(2)=0.01;b2=0.10,SE=0.02,η(2)=0.004,F=8.69,p<0.01)和外显自我抑郁联想(b1=0.10,SE=0.03,η(2)=0.02;b2=0.02,SE=0.04,F=7.50,p<0.01)与认知(b1)维度的相关性强于躯体(b2)维度。
研究样本包含了过多的抑郁患者。因此,将这些发现推广到一般人群可能存在问题。
认知病因因素可能在“认知”型抑郁中发挥作用。这些发现进一步证实了这样一种观点,即同质的抑郁症状测量方法比多维的抑郁概念能更准确地区分不同的亚型。