躯体化作为新发抑郁和焦虑的一个风险因素。

Somatisation as a risk factor for incident depression and anxiety.

作者信息

Dijkstra-Kersten Sandra M A, Sitnikova Kate, van Marwijk Harm W J, Gerrits Marloes M J G, van der Wouden Johannes C, Penninx Brenda W J H, van der Horst Henriëtte E, Leone Stephanie S

机构信息

Department of General Practice and Elderly Care Medicine, EMGO institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.

出版信息

J Psychosom Res. 2015 Dec;79(6):614-9. doi: 10.1016/j.jpsychores.2015.07.007. Epub 2015 Aug 3.

DOI:10.1016/j.jpsychores.2015.07.007

PMID:26253293

Abstract

OBJECTIVE

In this study, we aimed to examine somatisation as a risk factor for the onset of depressive and anxiety disorders.

METHODS

4-year follow-up data from the Netherlands Study of Depression and Anxiety (NESDA), a multisite cohort study of the course of depression and anxiety, was analysed. Participants (18-65 years) without a lifetime depressive or anxiety disorder at baseline were included (n=611). Somatisation was measured at baseline with the somatisation subscale of the 4 Dimensional Symptoms Questionnaire. Onset of depression and anxiety was assessed with the CIDI interview at 2-year and 4-year follow-up.

RESULTS

Somatisation was a risk factor for the incidence of depression [Hazard Ratio per unit increase (HR); 95% Confidence Interval (CI): 1.13; 1.09-1.17] and anxiety [HR; 95% CI: 1.14; 1.09-1.18]. Associations attenuated but remained statistically significant after adjusting for socio-demographic characteristics, chronic somatic disorders, and baseline levels of (subclinical) depressive or anxiety symptoms [adjusted HR for depression; 95% CI: 1.06; 1.00-1.12, adjusted HR for anxiety; 95% CI: 1.13; 1.07-1.20].

CONCLUSION

Persons who somatise have an increased risk of becoming depressed or anxious in subsequent years, over and above baseline levels of depressive or anxiety symptoms. They may represent a target group for prevention of depressive and anxiety disorders.

摘要

目的

在本研究中，我们旨在检验躯体化作为抑郁和焦虑障碍发病的一个风险因素。

方法

分析了荷兰抑郁与焦虑研究（NESDA）的4年随访数据，该研究是一项关于抑郁和焦虑病程的多中心队列研究。纳入了基线时无终生抑郁或焦虑障碍的参与者（18 - 65岁）（n = 611）。在基线时用4维度症状问卷的躯体化子量表测量躯体化。在2年和4年随访时用复合性国际诊断交谈检查表（CIDI）访谈评估抑郁和焦虑的发病情况。

结果

躯体化是抑郁发病的一个风险因素[每单位增加的风险比（HR）；95%置信区间（CI）：1.13；1.09 - 1.17]和焦虑发病的风险因素[HR；95% CI：1.14；1.09 - 1.18]。在调整了社会人口学特征、慢性躯体疾病以及（亚临床）抑郁或焦虑症状的基线水平后，关联减弱但仍具有统计学意义[抑郁的调整后HR；95% CI：1.06；1.00 - 1.12，焦虑的调整后HR；95% CI：1.13；1.07 - 1.20]。