Dijkstra-Kersten Sandra M A, Sitnikova Kate, Terluin Berend, Penninx Brenda W J H, Twisk Jos W R, van Marwijk Harm W J, van der Horst Henriette E, van der Wouden Johannes C
Department of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands.
Department of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands.
J Psychosom Res. 2017 Jun;97:96-101. doi: 10.1016/j.jpsychores.2017.04.015. Epub 2017 Apr 24.
To examine longitudinal associations of multiple physical symptoms with recurrence of depressive and anxiety disorders.
Follow-up data of 584 participants with remitted depressive or anxiety disorders were used from the Netherlands Study of Depressive and Anxiety disorders. Multiple physical symptoms were measured at baseline (T1) and two-year follow-up (T2) by the Four-Dimensional Symptom Questionnaire (4DSQ) somatization subscale. Recurrence of depressive and anxiety disorders was assessed at two-year (T2) and four-year (T4) follow-up with the Composite International Diagnostic Interview. Logistic Generalized Estimating Equations were used to examine associations of multiple physical symptoms with recurrence of depressive and anxiety disorders. Depressive (IDS-SR) and anxiety symptoms (BAI), and other relevant covariates were taken into account.
Multiple physical symptoms were significantly associated with recurrence of depression (OR=1.04, 95%CI=1.00-1.08), anxiety (OR=1.07, 95%CI=1.03-1.12), and depressive or anxiety disorders (OR=1.06, 95%CI=1.02-1.10), on average over time. Odds ratios did not change substantially when the IDS-SR mood-cognition and BAI subjective scale were included as covariates.
The presence of multiple physical symptoms was positively related to recurrence of depressive and anxiety disorders, independent of depressive and anxiety symptoms. Knowledge of risk factors for recurrence of depressive and anxiety disorders, such as the presence of multiple physical symptoms, could provide possibilities for better targeting interventions to prevent recurrence.
研究多种躯体症状与抑郁和焦虑障碍复发之间的纵向关联。
使用荷兰抑郁与焦虑障碍研究中584名缓解期抑郁或焦虑障碍参与者的随访数据。在基线期（T1）和两年随访期（T2），通过四维症状问卷（4DSQ）的躯体化分量表测量多种躯体症状。在两年（T2）和四年（T4）随访时，使用复合国际诊断访谈评估抑郁和焦虑障碍的复发情况。采用逻辑广义估计方程来研究多种躯体症状与抑郁和焦虑障碍复发之间的关联。同时考虑了抑郁症状（IDS-SR）、焦虑症状（BAI）以及其他相关协变量。
平均而言，随着时间推移，多种躯体症状与抑郁症复发（OR = 1.04，95%CI = 1.00 - 1.08）、焦虑症复发（OR = 1.07，95%CI = 1.03 - 1.12）以及抑郁或焦虑障碍复发（OR = 1.06，95%CI = 1.02 - 1.10）显著相关。当将IDS-SR情绪认知和BAI主观量表作为协变量纳入时，比值比没有实质性变化。
多种躯体症状的存在与抑郁和焦虑障碍的复发呈正相关，且独立于抑郁和焦虑症状。了解抑郁和焦虑障碍复发的危险因素，如多种躯体症状的存在，可为更有针对性地预防复发干预措施提供可能。
