Trick Leanne, Watkins Edward, Windeatt Stacey, Dickens Chris
University of Exeter Medical School, College House, St Lukes Campus, Heavitree Road, Exeter EX1 2LU, United Kingdom.
University of Exeter Medical School, College House, St Lukes Campus, Heavitree Road, Exeter EX1 2LU, United Kingdom.
J Psychosom Res. 2016 Dec;91:89-101. doi: 10.1016/j.jpsychores.2016.11.004. Epub 2016 Nov 12.
Depression is common in people with long term conditions, and is associated with worse medical outcomes. Previous research shows perseverative negative thinking (e.g. worry, rumination) predicts subsequent depression and worse medical outcomes, suggesting interventions targeting perseverative negative thinking could improve depression and medical outcomes. Previous studies recruited healthy individuals, however. This review aimed to determine the temporal relationship and strength of prospective association of perseverative negative thinking with depression, anxiety and emotional distress in people with long term conditions.
Four electronic databases were searched for studies including standardised measures of perseverative negative thinking and depression, anxiety or emotional distress, and which presented prospective associations. Findings were narratively synthesized.
Thirty studies were identified in a range of long term conditions. Perseverative negative thinking and subsequent depression, anxiety or emotional distress were significantly correlated in the majority of studies (bivariate r=0.23 to r=0.73). 25 studies controlled for confounders, and in 15 perseverative negative thinking predicted subsequent depression, anxiety or emotional distress. Results varied according to condition and study quality. Six of 7 studies found bivariate associations between depression, anxiety or emotional distress and subsequent perseverative negative thinking, though 2 studies controlling for key covariates found no association. Few studies assessed the impact of perseverative negative thinking on medical outcomes.
Strongest evidence supported perseverative negative thinking predicting subsequent depression, anxiety and emotional distress in people with long term conditions. Further prospective research is warranted to clarify the association of perseverative negative thinking with subsequent poor medical outcomes.
抑郁症在患有长期疾病的人群中很常见，并且与更差的医疗结果相关。先前的研究表明，持续性消极思维（如担忧、沉思）可预测随后的抑郁症及更差的医疗结果，这表明针对持续性消极思维的干预措施可能改善抑郁症及医疗结果。然而，先前的研究招募的是健康个体。本综述旨在确定持续性消极思维与患有长期疾病的人群的抑郁症、焦虑症及情绪困扰之间的时间关系及前瞻性关联的强度。
检索四个电子数据库，查找包含持续性消极思维以及抑郁症、焦虑症或情绪困扰的标准化测量方法且呈现前瞻性关联的研究。对研究结果进行叙述性综合分析。
在一系列长期疾病中确定了30项研究。在大多数研究中，持续性消极思维与随后的抑郁症、焦虑症或情绪困扰显著相关（双变量r = 0.23至r = 0.73）。25项研究对混杂因素进行了控制，其中15项研究表明持续性消极思维可预测随后的抑郁症、焦虑症或情绪困扰。结果因疾病情况和研究质量而异。7项研究中有6项发现抑郁症、焦虑症或情绪困扰与随后的持续性消极思维之间存在双变量关联，不过2项对关键协变量进行控制的研究未发现关联。很少有研究评估持续性消极思维对医疗结果的影响。
最有力的证据支持持续性消极思维可预测患有长期疾病的人群随后出现的抑郁症、焦虑症和情绪困扰。有必要进行进一步的前瞻性研究，以阐明持续性消极思维与随后不良医疗结果之间的关联。
