Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Institute for Translational Research in Biomedical Sciences, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
Int J Psychiatry Clin Pract. 2019 Nov;23(4):286-292. doi: 10.1080/13651501.2019.1638941. Epub 2019 Aug 29.
Attachment connects mood expressions and is related to the psychopathology of depression and anxiety. However, whether insecure attachment can predict the risk of an increased number of anxiety comorbidities in patients with major depressive disorder (MDD) remains unclear. Sixty-six patients with MDD were recruited in this cross-sectional study. Depression, anxiety and insecure attachment among patients were assessed accordingly. Patients' disease characteristics and psychopathology were evaluated using a structured psychiatric MINI interview, the 17-item Hamilton Depression Rating Scale, and the 21-item Beck Anxiety Inventory, while the attachment was assessed with the Chinese self-reporting version of the Attachment Style Questionnaire. We found that 74.2% of MDD patients had at least one anxiety comorbidity, and 24.2% of MDD patients had multiple anxiety comorbidities. Common anxiety comorbidities included generalised anxiety disorder, panic disorder, agoraphobia, and post-traumatic stress disorder. The patients who had multiple anxiety comorbidities exhibited lower secure attachment levels and higher anxious/preoccupied and avoidant attachment levels. Anxious/preoccupied attachment is associated with an increased risk of multiple anxiety comorbidities in MDD patients. A longitudinal study with a larger sample size is needed to identify the causal relationship of anxious/preoccupied attachment and anxiety comorbidities during the course of MDD.
依恋与情绪表达有关，并与抑郁和焦虑的精神病理学有关。然而，不安全的依恋是否可以预测患有重度抑郁症（MDD）的患者出现更多焦虑共病的风险尚不清楚。本横断面研究共招募了 66 名 MDD 患者。相应地评估了患者的抑郁、焦虑和不安全依恋情况。使用结构化精神病 MINI 访谈、17 项汉密尔顿抑郁评定量表和 21 项贝克焦虑量表评估患者的疾病特征和精神病理学，而使用依恋风格问卷的中文自报版本评估依恋情况。我们发现，74.2%的 MDD 患者至少有一种焦虑共病，24.2%的 MDD 患者有多种焦虑共病。常见的焦虑共病包括广泛性焦虑障碍、惊恐障碍、广场恐怖症和创伤后应激障碍。有多种焦虑共病的患者表现出较低的安全依恋水平和较高的焦虑/关注和回避依恋水平。焦虑/关注依恋与 MDD 患者多种焦虑共病的风险增加有关。需要进行一项具有更大样本量的纵向研究，以确定在 MDD 病程中焦虑/关注依恋和焦虑共病之间的因果关系。
