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肥胖患者中焦虑、抑郁与暴饮暴食症状之间共病的纵向模式:一项路径分析。

Longitudinal patterns of comorbidity between anxiety, depression and binge eating symptoms among patients with obesity: A path analysis.

作者信息

Duarte-Guerra Leorides Severo, Kortchmar Estela, Maraviglia Elaine Cristina Soares, Costa Thaís da Silva, Lasmar Camila Migliorin, Morin Regina Maria Rodrigues, Grossi Ivanimeire Oliveira, Villares Julia Faria, Cremonesi Mariane Carvalho, Watanuki Hugo Martinelli, Santo Marco Aurélio, Lotufo-Neto Francisco, Wang Yuan-Pang

机构信息

Department of Psychiatry, University of São Paulo Medical School, Rua Dr. Ovídio Pires de Campos, no. 785, 05403-010 - São Paulo - SP - Brasil.

Department of Psychiatry, University of São Paulo Medical School, Rua Dr. Ovídio Pires de Campos, no. 785, 05403-010 - São Paulo - SP - Brasil.

出版信息

J Affect Disord. 2022 Apr 15;303:255-263. doi: 10.1016/j.jad.2022.02.030. Epub 2022 Feb 14.

Abstract

BACKGROUND

Depression, anxiety, and binge eating are common psychiatric symptoms among people with obesity. Although many studies seek to understand the mechanisms of association between these psychiatric symptoms, there is no still consensus about the longitudinal association.

METHODS

155 patients (124 women) were recruited from a university-based bariatric center and evaluated over three waves (T0-T1-T2). In the last period the sample comprised 126 (104 women) participants. Trained clinicians assessed psychiatric symptoms by telephone interview using measurement scales. Partial Least Squares (PLS) was applied to investigate the path effects between anxiety, depression and binge eating symptoms over time.

RESULTS

The results of path coefficients (β) showed that the effect of anxiety on depression was constantly significant in all periods T0 (β = 0.74), T1 (β = 0.71), and T2 (β = 0.67). Anxiety had an effect on binge eating in T0 (β = 0.39) and T2 (β = 0.26) but not in T1. Binge eating affected depressive symptoms only in T2 (β = 0.22). Two carry-over-effects were significant binge eating in T0-T1 (β = 0.41) and T1-T2 (β = 0.19).

LIMITATIONS

Telephone interviews, social isolation due to the pandemic and the social desirability may have contributed to collection and information biases.

CONCLUSION

Anxiety has significant path effects on depression and binge eating. Binge eating was shown to be the most unstable symptom over time. The time factor seems to contribute to path effects between the psychiatric symptoms. The results draw attention to the fact that psychiatric symptoms must be evaluated and treated in association with each other, and investigated over time.

摘要

背景

抑郁、焦虑和暴饮暴食是肥胖人群常见的精神症状。尽管许多研究试图了解这些精神症状之间的关联机制,但关于纵向关联仍未达成共识。

方法

从一家大学附属的减肥中心招募了155名患者(124名女性),并在三个阶段(T0 - T1 - T2)进行评估。在最后阶段,样本包括126名(104名女性)参与者。训练有素的临床医生通过电话访谈使用测量量表评估精神症状。应用偏最小二乘法(PLS)来研究焦虑、抑郁和暴饮暴食症状随时间的路径效应。

结果

路径系数(β)结果显示,焦虑对抑郁的影响在所有阶段T0(β = 0.74)、T1(β = 0.71)和T2(β = 0.67)均持续显著。焦虑在T0(β = 0.39)和T2(β = 0.26)对暴饮暴食有影响,但在T1没有。暴饮暴食仅在T2影响抑郁症状(β = 0.22)。两个延续效应显著,即T0 - T1的暴饮暴食(β = 0.41)和T1 - T2的暴饮暴食(β = 0.19)。

局限性

电话访谈、疫情导致的社交隔离以及社会期望可能导致了收集和信息偏差。

结论

焦虑对抑郁和暴饮暴食有显著的路径效应。随着时间的推移,暴饮暴食被证明是最不稳定的症状。时间因素似乎对精神症状之间的路径效应有影响。结果提醒人们,精神症状必须相互关联地进行评估和治疗,并随时间进行研究。

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