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美国军事队列中应激性生活事件与抑郁症状轨迹。

Stressful life events and trajectories of depression symptoms in a U.S. military cohort.

机构信息

Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.

Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA.

出版信息

Sci Rep. 2022 Jun 30;12(1):11026. doi: 10.1038/s41598-022-14496-0.

Abstract

Depression is a common mental disorder that may comprise distinct, underlying symptom patterns over time. Associations between stressful life events throughout the civilian lifecourse-including during childhood-and adult depression have been documented in many populations, but are less commonly assessed in military samples. We identified different trajectories of depression symptoms across four years in a military cohort using latent class growth analysis, and investigated the relationship between these trajectories and two domains of civilian life experiences: childhood adversity (e.g., being mistreated during childhood) and more proximal stressful experiences (e.g., divorce). A four-group depression model was identified, including a symptom-free group (62%), an increasing symptom group (13%), a decreasing symptom group (16%), and a "chronic" symptom group (9%). Compared to the symptom-free group, soldiers with childhood adversity were more likely to be in the chronic depression, decreasing, and increasing symptom groups. Time-varying adult stressors had the largest effect on depression symptoms for the increasing symptom group compared to other groups, particularly in the last two years of follow-up. This study indicates the importance of considering events from throughout the lifecourse-not only those from deployment-when studying the mental health of servicemembers.

摘要

抑郁症是一种常见的精神障碍,随着时间的推移可能会包含不同的潜在症状模式。在许多人群中,已经记录了平民生活过程中(包括儿童时期)的压力性生活事件与成人抑郁症之间的关联,但在军事样本中较少评估。我们使用潜在类别增长分析在一个军事队列中确定了四年内抑郁症状的不同轨迹,并研究了这些轨迹与两个平民生活经历领域之间的关系:儿童逆境(例如,在童年时受到虐待)和更接近的压力经历(例如,离婚)。确定了一个四组抑郁模型,包括无症状组(62%)、症状增加组(13%)、症状减少组(16%)和“慢性”症状组(9%)。与无症状组相比,有儿童逆境的士兵更有可能处于慢性抑郁、症状减少和症状增加的组别中。与其他组别相比,时变的成年压力源对症状增加组的抑郁症状影响最大,尤其是在随访的最后两年。这项研究表明,在研究服役人员的心理健康时,考虑整个生命周期的事件(不仅是部署期间的事件)非常重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4464/9246834/13a187abebee/41598_2022_14496_Fig1_HTML.jpg

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