Department of Psychiatry, University of Saskatchewan, Ellis Hall Room 124 Royal University Hospital 103 Hospital Drive Saskatoon, Saskatoon, Saskatchewan, S7N 0W8, Canada.
Department of Psychiatry, University of Saskatchewan, Ellis Hall Room 124 Royal University Hospital 103 Hospital Drive Saskatoon, Saskatoon, Saskatchewan, S7N 0W8, Canada.
Psychiatry Res. 2018 Nov;269:86-92. doi: 10.1016/j.psychres.2018.08.037. Epub 2018 Aug 14.
Major depressive disorder (MDD) frequently co-occurs with social anxiety disorder (SAD), and their comorbidity (MDD-SAD) increases clinical severity and functional impairment. Still, the specific psychological vulnerabilities of individuals with MDD-SAD are poorly understood. Individual attachment characteristics develop early in life through interactions with primary caregivers, and tend to persist throughout life. Early trauma can worsen attachment insecurity, increasing the risk for future anxiety and depression. The purpose of this study is to examine differences in individual attachment and history of trauma in depressed individuals with or without comorbid SAD and controls. One hundred sixty-two participants were categorized into three groups based on SCID-I interview: healthy controls (HC), individuals with current MDD without SAD (MDD), and individuals with current MDD comorbid with SAD (MDD-SAD). MDD-SAD group had significantly greater attachment anxiety and attachment avoidance compared to the MDD and HC groups. MDD-SAD group had greater clinician-rated depression severity and dysfunction compared to MDD group. In summary, the study further supports the clinical risks associated with MDD-SAD and suggests that insecure attachment might represent an associated vulnerability and a possible pathway which warrants further research and clinical attention.
重度抑郁症（MDD）常与社交焦虑症（SAD）共病，其共病（MDD-SAD）增加了临床严重程度和功能障碍。尽管如此，MDD-SAD 患者的具体心理脆弱性仍了解甚少。个体依恋特征是通过与主要照顾者的互动在生命早期发展起来的，并且往往会持续一生。早期创伤会使依恋不安全感恶化，增加未来焦虑和抑郁的风险。本研究旨在探讨在无共病 SAD 和对照组的 MDD 患者中，个体依恋和创伤史的差异。根据 SCID-I 访谈，162 名参与者被分为三组：健康对照组（HC）、当前无 SAD 的 MDD 患者（MDD）和当前伴有 SAD 的 MDD 患者（MDD-SAD）。与 MDD 和 HC 组相比，MDD-SAD 组的依恋焦虑和依恋回避显著更高。与 MDD 组相比，MDD-SAD 组的临床医生评定的抑郁严重程度和功能障碍更大。总之，该研究进一步支持了 MDD-SAD 相关的临床风险，并表明不安全依恋可能代表一种相关的脆弱性，是一个值得进一步研究和临床关注的潜在因素。
