Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Department of Mental Disorders, Norwegian Institute of Public Health, Norway; Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland.
J Affect Disord. 2018 Oct 15;239:107-114. doi: 10.1016/j.jad.2018.07.007. Epub 2018 Jul 3.
Hopelessness is a common experience of patients with depressive disorders (DD) and an important predictor of suicidal behaviour. However, stability and factors explaining state and trait variation of hopelessness in patients with DD over time are poorly known.
Patients with DD (n = 406) from the Vantaa Depression Study and the Vantaa Primary Care Depression Study filled in the Beck Hopelessness Scale (BHS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Perceived Social Support Scale-Revised (PSSS-R), and Eysenck Personality Inventory-Q (EPI-Q) at baseline, at six and eighteen months, and at five years. We conducted a multilevel linear regression analyses predicting BHS with these covariates.
During the five-year follow-up half of the variance in BHS was attributable to between-patient variance (50.6%, CI = 41.2-61.5%), and the rest arose from within-patient variance and measurement errors. BDI and BAI explained 5.6% of within-patient and 28.4% of between-patient variance of BHS. High Neuroticism and low Extraversion explained 2.6% of the between-patient variance of BHS. PSSS-R explained 5% of between-patient variance and 1.7% of within-patient variance of BHS.
No treatment effects were controlled.
Hopelessness varies markedly over time both within and between patients with depression; it is both state- and trait-related. Concurrent depressive and anxiety symptoms and low social support explain both state and trait variance, whereas high Neuroticism and low Extraversion explain only trait variance of hopelessness. These variations influence the utility of hopelessness as an indicator of suicide risk.
绝望是抑郁症患者的常见体验，也是自杀行为的重要预测因素。然而，抑郁症患者的绝望状态和特质随时间的稳定性以及解释其状态和特质变化的因素知之甚少。
来自万塔抑郁研究和万塔初级保健抑郁研究的抑郁症患者（n=406）在基线、6 个月、18 个月和 5 年内填写贝克绝望量表（BHS）、贝克抑郁量表（BDI）、贝克焦虑量表（BAI）、修订后的感知社会支持量表（PSSS-R）和艾森克人格问卷-Q（EPI-Q）。我们使用这些协变量进行了多水平线性回归分析，预测 BHS。
在五年的随访中，BHS 的一半方差归因于患者间方差（50.6%，CI=41.2-61.5%），其余部分来自患者内方差和测量误差。BDI 和 BAI 解释了 BHS 患者内方差的 5.6%和患者间方差的 28.4%。高神经质和低外向性解释了 BHS 患者间方差的 2.6%。PSSS-R 解释了 BHS 患者间方差的 5%和患者内方差的 1.7%。
未控制治疗效果。
抑郁症患者的绝望状态在时间上存在显著的个体内和个体间差异；它既是状态相关的，也是特质相关的。同时存在的抑郁和焦虑症状以及低社会支持既解释了状态方差，也解释了特质方差，而高神经质和低外向性仅解释了绝望的特质方差。这些变化影响了绝望作为自杀风险指标的实用性。
