Picardi Angelo, Pallagrosi Mauro, Fonzi Laura, Martinotti Giovanni, Caroppo Emanuele, Meldolesi Giulio Nicolò, Di Gennaro Giancarlo, De Risi Marco, Biondi Massimo
Centre of Behavioural Sciences and Mental Health, Italian National Institute of Health, Rome, Italy.
Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy.
Clin Pract Epidemiol Ment Health. 2019 Dec 31;15:143-152. doi: 10.2174/1745017901915010143. eCollection 2019.
A link between depression and insecure attachment has long been postulated. Although many studies examined the relationship between depressive symptoms and attachment, relatively few studies were performed on patients diagnosed with depression. Also, research on patients with bipolar disorder is scarce.
We aimed at testing the association between attachment insecurity and unipolar and bipolar depression.
We studied 21 patients with bipolar disorder, current episode depressed, and three age- and sex-matched groups, each consisting of 21 individuals: patients with major depressive disorder, recurrent episode; patients with epilepsy; non-clinical participants. The Experience in Close Relationships questionnaire was used to assess adult attachment style.
Patients with both bipolar and unipolar depression displayed significantly higher scores on attachment-related avoidance as compared with patients with epilepsy and non-clinical participants. Also, patients with bipolar depression scored significantly higher on attachment-related anxiety than all other groups. In both psychiatric groups, attachment dimensions were not significantly correlated with global clinical severity or severity of depression.
Despite some study limitations, our results are consistent with some previous studies and provide support to Bowlby's seminal hypothesis that attachment insecurity may predispose to depression. Attachment theory may provide a valuable theoretical framework for future research and for guiding treatment.
长期以来，人们一直假定抑郁症与不安全依恋之间存在联系。尽管许多研究探讨了抑郁症状与依恋之间的关系，但针对被诊断为抑郁症患者的研究相对较少。此外，关于双相情感障碍患者的研究也很匮乏。
我们旨在检验不安全依恋与单相和双相抑郁症之间的关联。
我们研究了21例双相情感障碍且当前为抑郁发作的患者，以及三个年龄和性别匹配的组，每组由21人组成：复发性重度抑郁症患者；癫痫患者；非临床参与者。使用亲密关系体验问卷来评估成人依恋风格。
与癫痫患者和非临床参与者相比，双相和单相抑郁症患者在依恋相关回避方面的得分显著更高。此外，双相抑郁症患者在依恋相关焦虑方面的得分显著高于所有其他组。在两个精神疾病组中，依恋维度与整体临床严重程度或抑郁严重程度均无显著相关性。
尽管本研究存在一些局限性，但我们的结果与先前的一些研究一致，并为鲍尔比的开创性假设提供了支持，即不安全依恋可能易患抑郁症。依恋理论可能为未来的研究和治疗指导提供有价值的理论框架。
