Department of Psychology, Pusan National University, Busan, Republic of Korea.
Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea.; Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, Republic of Korea.
J Affect Disord. 2020 Jul 1;272:432-439. doi: 10.1016/j.jad.2020.03.162. Epub 2020 Apr 30.
We aimed to investigate the gender differences in the associations between the individual symptoms of AUD and MDD and SB using a network analysis.
Data from the 2011 and 2016 Korean Epidemiologic Catchment Area Study were analyzed. Variables were assessed using the Korean version of Composite International Diagnostic Interview. Of 11,124 total participants, 907 endorsing screening questions for AUD and MDD were included. The undirected and directed network structures of AUD, MDD, and SB were estimated and centrality and bridge centrality indices were examined.
The overall undirected network structure and global strength did not differ between genders. While three AUD symptoms had high strength indices in network structure for both genders, depressed mood for men and worthlessness/guilt for women were the bridge symptoms linking other MDD symptoms and AUD symptoms to SB and had the strongest influence on SB. Directed network indicated that for men, AUD symptoms were related to SB via MDD symptoms with tolerance being a dominant item. For women, none of the AUD symptoms were related to MDD symptoms and SB, and insomnia/hypersomnia was a dominant item. Worthlessness/guilt was the directly linked to SB in the directed network analysis for both genders.
Cross-sectional design and the use of combined dataset with different time points.
Some differential associations at the level of individual symptoms of AUD and MDD with SB were observed between men and women. Targeting to the central and bridging symptoms may improve the outcomes of SB interventions implemented among patients with AUD or MDD.
本研究旨在采用网络分析方法，探究 AUD 和 MDD 各症状与 SB 之间的关联在性别上的差异。
本研究使用 2011 年和 2016 年韩国流行病学抽样调查的数据进行分析。采用韩国版复合国际诊断访谈对变量进行评估。在总共 11124 名参与者中，纳入了 907 名 AUD 和 MDD 筛查阳性者。对 AUD、MDD 和 SB 的无向和有向网络结构进行了估计，并对中心性和桥接中心性指标进行了检验。
男女之间的总体无向网络结构和全局强度并无差异。尽管 AUD 的三个症状在两性的网络结构中都具有较高的强度指标，但男性的情绪低落和女性的无价值感/内疚感是将其他 MDD 症状与 AUD 症状联系起来并对 SB 具有最强影响的桥接症状。有向网络表明，对于男性来说，AUD 症状通过 MDD 症状与 SB 相关，其中耐受是一个主要的项目。对于女性来说，AUD 症状与 MDD 症状和 SB 均无关，失眠/嗜睡是一个主要的项目。在有向网络分析中，无价值感/内疚感是男女之间与 SB 直接相关的症状。
横断面设计以及使用具有不同时间点的组合数据集。
在 AUD 和 MDD 的各症状与 SB 之间的关联上，男女之间存在一些差异。针对中心和桥接症状可能会改善在 AUD 或 MDD 患者中实施的 SB 干预的结果。
