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
Department of General Practice and Elderly Care Medicine, EMGO institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
Department of General Practice and Elderly Care Medicine, EMGO institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
J Psychosom Res. 2015 Dec;79(6):614-9. doi: 10.1016/j.jpsychores.2015.07.007. Epub 2015 Aug 3.
In this study, we aimed to examine somatisation as a risk factor for the onset of depressive and anxiety disorders.
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.
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].
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.
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。
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。
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]。
有躯体化表现的人在随后几年中出现抑郁或焦虑的风险增加，超过了抑郁或焦虑症状的基线水平。他们可能是预防抑郁和焦虑障碍的目标群体。
