Department of Psychiatry, Weill Cornell Medicine (AW, NS, BL, AG, JAS), White Plains, NY.
Department of Psychiatry and Behavioral Sciences, University of California at Davis (HCK), CA.
Am J Geriatr Psychiatry. 2021 Aug;29(8):843-852. doi: 10.1016/j.jagp.2020.12.021. Epub 2021 Jan 5.
Social isolation is highly common in late life and is associated with devastating mental health and physical outcomes. This study investigated whether components of social isolation (marital status, perceived social support, and interpersonal problems) predict change in depression severity over the course of a brief adherence intervention delivered in a primary care setting.
A sample of 189 older adults with major depressive disorder were randomized to either an adherence intervention, "Treatment Initiation Program," or treatment as usual. Marital status, perceived social support and interpersonal problems were assessed at baseline. A mixed-effects regression was used to test whether these factors predicted the change trajectory in depression severity over 24 weeks.
Being married (F(2,176) = 6.60; p = 0.001), reporting higher perceived social support (F(2,177) = 4.70; p = 0.01), and fewer interpersonal problems (F(2, 176) = 4.34; p = 0.01) predicted lower depression severity on average over the course of 24 weeks.
Social variables such as living in partnership, perceiving others as supportive, and reporting few interpersonal problems may reduce older adults' vulnerability to depression and enhance their ability to benefit from treatment. These findings can guide development of interventions that will target these social factors early in treatment to increase efficacy.
社交孤立在晚年人群中非常普遍，与严重的心理健康和身体后果有关。本研究调查了社交孤立的组成部分（婚姻状况、感知社会支持和人际关系问题）是否可以预测在初级保健环境中进行的短暂依从性干预过程中抑郁严重程度的变化。
189 名患有重度抑郁症的老年人被随机分为依从性干预组（“治疗启动计划”）或常规治疗组。在基线时评估婚姻状况、感知社会支持和人际关系问题。使用混合效应回归来测试这些因素是否可以预测抑郁严重程度在 24 周内的变化轨迹。
已婚（F（2,176）= 6.60；p = 0.001）、报告较高的感知社会支持（F（2,177）= 4.70；p = 0.01）和较少的人际关系问题（F（2, 176）= 4.34；p = 0.01）平均预测在 24 周的过程中抑郁严重程度较低。
社交变量，如处于伴侣关系中、感知他人的支持以及报告人际关系问题较少，可能会降低老年人患抑郁症的脆弱性，并增强他们从治疗中受益的能力。这些发现可以指导开发干预措施，以便在治疗早期针对这些社会因素，提高疗效。
