Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, USA.
Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, USA; Center for Healthy Aging, The Pennsylvania State University, University Park, PA, USA; Penn State Milton S. Hershey Medical Center, The Pennsylvania State University, PA, USA.
J Affect Disord. 2021 Feb 15;281:367-375. doi: 10.1016/j.jad.2020.11.105. Epub 2020 Nov 17.
Examining variability in the presenting symptoms of depression may be particularly important in characterizing depression in patients with comorbid conditions such as obesity. Identifying the underlying constructs of depression in such patients may produce phenotypic information to aid diagnosis and treatment decisions.
To examine the latent factors of symptoms using the depression Symptom Checklist (SCL-20) and the Patient Health Questionnaire (PHQ-9), separately, in patients with obesity and elevated depressive symptoms.
Exploratory factor analysis (EFA) was performed on baseline data from 409 patients with obesity and elevated depressive symptoms recruited in primary care. Bootstrap analysis was performed to estimate the precision and potential replicability of identified latent factors.
Participants (70% women, mean age of 51.0 ± 12.1 years) had moderate depression. EFA of the SCL-20 suggested two reliable factors: dysphoric mood (71% of the variance) and anhedonia (15% of the variance). EFA of the PHQ-9 yielded one factor: dysphoric mood (87% of the variance). Bootstrapped results supported the replicability of these results. The top most endorsed symptoms were feeling low energy, overeating and disturbed sleep.
The generalizability of these findings to severe depression may be limited.
Patients with elevated depressive symptoms and obesity present with heterogeneous symptoms. The SCL-20 seems more sensitive than the PHQ-9 for differentiating symptom profiles in this population. Some possible reasons include: 1) differences in number of scale items, and 2) differences in the aspects of depression they tap into; the SCL-20 measures the severity of symptoms, whereas the PHQ-9 measures the frequency of symptoms.
在肥胖等合并症患者中，检查抑郁的表现症状的变异性可能对描述抑郁尤其重要。在这些患者中确定抑郁的潜在结构可能会产生表型信息，以帮助诊断和治疗决策。
使用抑郁症状清单（SCL-20）和患者健康问卷（PHQ-9）分别检查肥胖和抑郁症状升高患者的症状潜在因素。
对来自初级保健中招募的 409 名肥胖和抑郁症状升高的患者的基线数据进行探索性因素分析（EFA）。采用自举分析来估计确定的潜在因素的精度和潜在可重复性。
参与者（70%为女性，平均年龄为 51.0±12.1 岁）有中度抑郁。SCL-20 的 EFA 提示存在两个可靠因素：心境恶劣（占 71%的方差）和快感缺失（占 15%的方差）。PHQ-9 的 EFA 产生了一个因素：心境恶劣（占 87%的方差）。自举结果支持这些结果的可重复性。最受认可的症状是感觉精力不足、暴饮暴食和睡眠紊乱。
这些发现对重度抑郁的普遍性可能有限。
抑郁症状升高和肥胖的患者表现出异质的症状。SCL-20 似乎比 PHQ-9 更能区分该人群的症状特征。可能的原因包括：1）量表项目数量的差异，以及 2）它们所涉及的抑郁方面的差异；SCL-20 测量症状的严重程度，而 PHQ-9 测量症状的频率。
