Simning Adam, Seplaki Christopher L, Conwell Yeates
University of Rochester, Department of Psychiatry, USA.
University of Rochester, Department of Public Health Sciences, USA; University of Rochester Medical Center Office for Aging Research and Health Services, USA.
J Affect Disord. 2016 Mar 15;193:130-6. doi: 10.1016/j.jad.2015.12.079. Epub 2016 Jan 6.
While low social support is a risk factor for mental illness, anxiety and depression's relationship with social impairment specifically resulting from a medical condition is poorly understood. We hypothesize that when a medical illness makes it difficult for people to form and maintain close relationships with others, they will be at increased risk for anxiety and depression.
Two nationally representative surveys, the National Comorbidity Survey-Replication and National Latino and Asian American Study, included 6805 adults with at least one medical illness and information on social impairment attributed to a medical condition. The Composite International Diagnostic Interview evaluated a 12-month history of anxiety and depressive disorders.
8.2% of our sample had at least moderate difficulty in forming and maintaining close relationships due to a medical condition. In bivariate analyses, younger age, Latino ethnicity, less education, worse financial status, more chronic illnesses, physical health and discomfort, and problems with mobility, home management, and self-care were associated with this social impairment. In multivariable analyses accounting for possible confounders, there was a dose-dependent relationship between social impairment and the prevalence of anxiety and depression.
Data are cross-sectional and our analyses are therefore unable to determine cause-and-effect relationships.
Among adults with one or more medical conditions, social impairment attributed to medical illness was associated with a significantly greater odds of anxiety and depression. Further clarification of this relationship could inform more targeted, personalized interventions to prevent and/or alleviate mental illness in those with chronic medical conditions.
虽然社会支持不足是精神疾病的一个风险因素,但焦虑和抑郁与因医疗状况导致的社会功能损害之间的关系却鲜为人知。我们假设,当一种疾病使人们难以与他人建立和维持亲密关系时,他们患焦虑和抑郁的风险就会增加。
两项具有全国代表性的调查,即全国共病调查复制版和全国拉丁裔及亚裔美国人研究,纳入了6805名患有至少一种疾病且有因疾病导致社会功能损害信息的成年人。综合国际诊断访谈评估了12个月的焦虑和抑郁障碍病史。
在我们的样本中,8.2%的人因疾病在建立和维持亲密关系方面至少有中度困难。在双变量分析中,年龄较小、拉丁裔种族、教育程度较低、经济状况较差、慢性病较多、身体健康和不适以及行动、家庭管理和自我护理方面的问题与这种社会功能损害有关。在考虑了可能的混杂因素的多变量分析中,社会功能损害与焦虑和抑郁的患病率之间存在剂量依赖关系。
数据是横断面的,因此我们的分析无法确定因果关系。
在患有一种或多种疾病的成年人中,因疾病导致的社会功能损害与焦虑和抑郁的显著更高几率相关。对这种关系的进一步阐明可为预防和/或减轻慢性病患者的精神疾病提供更有针对性、个性化的干预措施提供依据。