VA Portland Health Care System, HSR&D Center to Improve Veteran Involvement in Care (CIVIC), 3710 SW US Veterans Hospital Rd (R&D 66), Portland, OR 97239-2964, United States; Oregon Health & Science University, Department of Psychiatry, 3181 SW Sam Jackson Park Rd (Multnomah Pavilion, Room 2316), Portland, OR 97239-3098, United States; Oregon Health & Science University and Portland State University, School of Public Health, 506 SW Mill St, Suite 450 (OMPH-SCH), Portland, OR 97201-5404, United States.
VA Portland Health Care System, HSR&D Center to Improve Veteran Involvement in Care (CIVIC), 3710 SW US Veterans Hospital Rd (R&D 66), Portland, OR 97239-2964, United States.
J Affect Disord. 2018 Apr 1;230:42-49. doi: 10.1016/j.jad.2018.01.003. Epub 2018 Jan 17.
Although the substantial influence of social relationships on health is well-known, studies that concurrently examine the influence of varying dimensions of social connectedness on major depression are more limited. This study's aim was to determine to what degree several facets of social connectedness (number of confidants, social support, interpersonal conflict, social norms, and loneliness) are correlated with depression-related outcomes.
Participants were primary care patients (n = 301) with probable major depression at a Veterans Health Administration hospital and its satellite clinics. Social connectedness was primarily measured using multi-item instruments from the NIH Toolbox of Adult Social Relationship Scales. Primary outcomes were clinical symptoms (depression and suicidal ideation) and secondary outcomes were self-reported health-related behaviors (medication adherence, patient activation, and help-seeking intentions).
In multivariate models adjusting for potential confounders and other facets of connectedness, loneliness was associated with higher levels of depression and suicidal ideation, as well as lower patient activation and help-seeking intentions. Social support and social norms about depression treatment were each associated with higher patient activation and help-seeking intentions. Social connectedness was not associated with medication adherence.
The limitations of this study are primarily related to its cross-sectional survey design and study population.
Multiple aspects of social connectedness are associated with depression outcomes among military veterans with depression. Loneliness may represent the most important component of connectedness, as it is associated with depression severity, suicidality, and health-related behaviors.
尽管社会关系对健康有实质性的影响已广为人知，但同时研究各种社会联系维度对重度抑郁症的影响的研究则更为有限。本研究旨在确定社会联系的几个方面（知己数量、社会支持、人际冲突、社会规范和孤独感）与与抑郁相关的结果的相关程度。
参与者为退伍军人健康管理局医院及其卫星诊所的初级保健患者（n=301），患有可能的重度抑郁症。社会联系主要使用 NIH 成人社会关系量表工具包中的多项目量表进行测量。主要结果是临床症状（抑郁和自杀意念），次要结果是自我报告的健康相关行为（药物依从性、患者激活和寻求帮助的意愿）。
在调整潜在混杂因素和其他联系方面的多变量模型中，孤独感与更高水平的抑郁和自杀意念以及较低的患者激活和寻求帮助的意愿相关。社会支持和关于抑郁治疗的社会规范与更高的患者激活和寻求帮助的意愿相关。社会联系与药物依从性无关。
本研究的主要局限性在于其横断面调查设计和研究人群。
社会联系的多个方面与患有抑郁症的退伍军人的抑郁结果有关。孤独感可能是联系的最重要组成部分，因为它与抑郁严重程度、自杀意念和健康相关行为有关。
