Department of Psychiatry, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo 173-8610, Japan.
Department of Psychiatry, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo 173-8610, Japan.
J Affect Disord. 2018 Oct 1;238:482-488. doi: 10.1016/j.jad.2018.06.024. Epub 2018 Jun 6.
The following question remains open: what has the strongest impact on symptoms of depression, experiencing multiple stressful events, being exposed to a specific stressful event, or having a maladaptive coping style?
We conducted a cross-sectional survey with face-to-face interviews. Data from 2559 randomly-sampled adults living in Japan were analyzed. The participants were asked about stressful events (12 items) experienced in the previous month and their stress-coping strategies (16 items). Presence of symptoms of depression was defined using the Center for Epidemiologic Studies Depression scale. Logistic regression analysis was used to assess the associations of stressful events and stress-coping strategies with symptoms of depression.
The prevalence of symptoms of depression increased with the number of stressful events. Eight stressful events and five stress-coping strategies were positively associated with symptoms of depression. In the multiple logistic regression analysis for the items that showed a significant association with symptoms of depression, two stressful events ("Health/illness of self" and "Trouble with family members") and two stress-coping strategies ("Smoking" and "Bearing without action") remained significantly associated with symptoms of depression; however, the "dose effect" of the number of stressful events disappeared, suggesting that these stressful events and stress-coping strategies have a stronger association with symptoms of depression compared with experiencing multiple stressful events.
Since this study was cross-sectional in design, causal relationships could not be determined.
Our findings may indicate the importance of focusing on types of stressful events and coping styles in developing preventive strategies for major depression.
以下问题仍未得到解答：是什么对抑郁症状的影响最大，是经历多个压力事件、暴露于特定压力事件还是采用适应不良的应对方式？
我们进行了一项横断面调查，采用面对面访谈。分析了 2559 名随机抽样的日本成年人的数据。要求参与者报告上个月经历的压力事件（12 项）及其应对压力的策略（16 项）。采用流行病学研究中心抑郁量表定义抑郁症状的存在。采用逻辑回归分析评估压力事件和应对策略与抑郁症状之间的关联。
抑郁症状的患病率随压力事件数量的增加而增加。8 项压力事件和 5 项应对策略与抑郁症状呈正相关。在与抑郁症状显著相关的项目的多因素逻辑回归分析中，有两项压力事件（“自身健康/疾病”和“与家庭成员的矛盾”）和两项应对策略（“吸烟”和“不作为”）仍与抑郁症状显著相关；然而，压力事件数量的“剂量效应”消失，这表明这些压力事件和应对策略与抑郁症状的关联比经历多个压力事件更强。
由于本研究为横断面设计，因此无法确定因果关系。
我们的研究结果可能表明，在制定预防重度抑郁症的策略时，关注压力事件的类型和应对方式很重要。
