de Figueiredo John M, Zhu Boheng, Patel Amar, Kohn Robert, Koo Brian B, Louis Elan D
Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States.
Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Front Psychiatry. 2022 May 10;13:876445. doi: 10.3389/fpsyt.2022.876445. eCollection 2022.
The objective of this study was to determine whether depression and anxiety are mediators between perceived stress and demoralization via a loss of the cognitive map to get out of the predicament manifesting as subjective incompetence.
Ninety-five consecutive outpatients with Parkinson's disease were evaluated for perceived stress, depression, anxiety, subjective incompetence, and demoralization using reliable and valid scales. Inclusion criteria were ages 40-90, intact cognition, and no current history of substance use. The setting was a Movement Disorders Clinic at a university-affiliated hospital. The outcome variable was demoralization, selected . Mediators between perceived stress and demoralization were examined using path analysis.
Depression, anxiety, and subjective incompetence were mediators between perceived stress and demoralization. Among all variables, subjective incompetence was the largest contributor to demoralization. Depression connected to demoralization indirectly via subjective incompetence (β = 0.25, < 0.001), whereas anxiety bypassed subjective incompetence (β = -0.01, = 0.882), connecting directly to demoralization (β = 0.37, = 0.008).
Early treatment and reversal of subjective incompetence and anxiety could potentially prevent the escalation of demoralization and the associated disruption in health-related quality of life and eventual suicide.
本研究的目的是确定抑郁和焦虑是否是通过认知地图丧失以摆脱表现为主观无能的困境而在感知压力和士气低落之间起中介作用。
使用可靠且有效的量表对95名连续的帕金森病门诊患者进行感知压力、抑郁、焦虑、主观无能和士气低落的评估。纳入标准为年龄40 - 90岁、认知完整且无当前物质使用史。研究地点为一家大学附属医院的运动障碍诊所。结果变量是士气低落，通过路径分析检验感知压力和士气低落之间的中介因素。
抑郁、焦虑和主观无能是感知压力和士气低落之间的中介因素。在所有变量中，主观无能是导致士气低落的最大因素。抑郁通过主观无能间接与士气低落相关（β = 0.25，< 0.001），而焦虑绕过主观无能（β = -0.01，= 0.882），直接与士气低落相关（β = 0.37，= 0.008）。
早期治疗并扭转主观无能和焦虑可能潜在地预防士气低落的加剧以及相关的健康相关生活质量破坏和最终的自杀行为。
