述情障碍在首发急性冠状动脉综合征患者中预测抑郁发生的作用。

The role of alexithymia in predicting incident depression in patients at first acute coronary syndrome.

机构信息

Department of Neuroscience, Psychiatry Unit, Università degli Studi di Parma, Parma, Italy; Mental Health Department, AUSL, Parma, Italy.

Department of Neuroscience, Psychiatry Unit, Università degli Studi di Parma, Parma, Italy.

出版信息

Compr Psychiatry. 2015 Oct;62:86-92. doi: 10.1016/j.comppsych.2015.06.013. Epub 2015 Jun 23.

DOI:10.1016/j.comppsych.2015.06.013

PMID:26343471

Abstract

OBJECTIVE

Alexithymia has been considered both to predispose to depression and to worsen cardiac prognosis after an acute coronary syndrome. Nonetheless, no studies have evaluated its role as a risk factor for incident depression, in patients with acute coronary syndrome.

METHODS

In 251 consecutive patients, the presence of a first-ever depressive episode was evaluated with the Primary Care Evaluation of Mental Disorders at baseline and 1, 2, 4, 6, 9, 12 and 24 months after their first acute coronary syndrome. At baseline, patients completed the Toronto Alexithymia Scale (TAS-20) and the Hospital Anxiety and Depression Scale.

RESULTS

Out of 251 subjects (80.9% males), a first-ever depressive episode was diagnosed in 66 patients. Depressed and never-depressed patients differed in female gender, living status, alexithymic scores at TAS-20 and depressive symptoms. Nonetheless, nor the TAS-20 factors nor its total score were predictive of developing a depressive episode in a Cox regression. Moreover, baseline differences in TAS-20 scores between the two groups, disappeared after controlling for anhedonic symptoms.

CONCLUSION

Our results do not support the hypothesis that alexithymia at TAS-20 is a risk factor for incident depression after acute coronary syndrome.

摘要

目的

述情障碍既被认为是抑郁的易患因素，也被认为是急性冠状动脉综合征后心脏预后恶化的因素。然而，尚无研究评估述情障碍作为急性冠状动脉综合征患者新发抑郁的危险因素的作用。

方法

在 251 例连续患者中，在首次急性冠状动脉综合征后 1、2、4、6、9、12 和 24 个月，使用初级保健精神障碍评估对首次抑郁发作的发生进行评估。基线时，患者完成了多伦多述情障碍量表（TAS-20）和医院焦虑和抑郁量表。

结果

在 251 名患者中（80.9%为男性），有 66 名患者被诊断为首次出现抑郁发作。抑郁和非抑郁患者在性别、生活状况、TAS-20 的述情障碍评分和抑郁症状方面存在差异。然而，Cox 回归分析并未显示 TAS-20 各因子及其总分是发生抑郁发作的预测因素。此外，在控制了快感缺失症状后，两组间 TAS-20 评分的基线差异消失。