Lam Kevin F Y, Lim Haikel A, Tan Joyce Y S, Mahendran Rathi
Department of Psychological Medicine, National University of Singapore, NUHS Tower Block, Level 9, 1E Kent Ridge Road, 119228, Singapore.
Department of Psychological Medicine, National University of Singapore, NUHS Tower Block, Level 9, 1E Kent Ridge Road, 119228, Singapore; Department of Psychological Medicine, National University Hospital, NUHS Tower Block, Level 9, 1E Kent Ridge Road, 119228, Singapore; Duke-NUS Graduate Medical School Singapore, 8 College Road, 169857, Singapore.
Compr Psychiatry. 2015 Aug;61:49-56. doi: 10.1016/j.comppsych.2015.06.001. Epub 2015 Jun 6.
Given the high prevalence of cancer patients with comorbid depression, the present study sought to elucidate the relationships between two vulnerability factors, dysfunctional attitudes and rumination, and their influence on non-somatic depressive symptomatology in an Asian cohort of cancer patients. It was hypothesized that all variables of interest would be inter-correlated, and that both dysfunctional attitudes and rumination would mediate one another in influencing non-somatic depressive symptoms.
A total of 194 recently diagnosed mixed-cancer patients in Singapore (Mage=49.2±9.2years; 68% women; 61% ethnically Chinese), without any comorbid psychiatric diagnosis, completed the Dysfunctional Attitudes Scale Form A, Rumination Responses Scale (comprising brooding and reflective rumination), and Hospital Anxiety and Depression Scale.
Correlational analyses revealed that all variables were inter-correlated (rhos[194]=.35-.52). Bootstrapping mediation analyses controlling for gender and treatment received revealed that both brooding and reflective rumination mediated the relationship between dysfunctional attitudes and non-somatic depressive symptoms, and that dysfunctional attitudes also mediated the relationship between both brooding and reflective rumination and non-somatic depressive symptoms.
Findings suggest that, in cancer patients, both dysfunctional attitudes and rumination seem to act upon one other, in a feedback loop, to influence non-somatic depressive symptomatology. Clinicians may therefore have a wider range of treatments to choose from in managing cancer patients with depressive symptomatology.
鉴于癌症合并抑郁症患者的高患病率,本研究旨在阐明功能失调性态度和沉思这两个脆弱因素之间的关系,以及它们对亚洲癌症患者队列中非躯体性抑郁症状的影响。研究假设所有感兴趣的变量将相互关联,并且功能失调性态度和沉思在影响非躯体性抑郁症状方面会相互介导。
新加坡共有194名最近确诊的混合癌症患者(年龄中位数=49.2±9.2岁;68%为女性;61%为华裔),无任何合并精神疾病诊断,完成了功能失调性态度量表A型、沉思反应量表(包括沉思和反思性沉思)以及医院焦虑抑郁量表。
相关分析显示所有变量均相互关联(相关系数[194]=.35-.52)。控制性别和接受的治疗进行的自助法中介分析表明,沉思和反思性沉思均介导了功能失调性态度与非躯体性抑郁症状之间的关系,并且功能失调性态度也介导了沉思和反思性沉思与非躯体性抑郁症状之间的关系。
研究结果表明,在癌症患者中,功能失调性态度和沉思似乎在一个反馈循环中相互作用,以影响非躯体性抑郁症状。因此,临床医生在管理有抑郁症状的癌症患者时可能有更广泛的治疗选择。