Ruisoto Pablo, López-Guerra Víctor Manuel, López-Núñez Carla, Sánchez-Puertas Rafael, Paladines-Costa María Belén, Pineda-Cabrera Nairoby Jackeline
Department of Health Sciences, Public University of Navarre, Pamplona, Spain.
Department of Psychology, Particular Technical University of Loja, Loja, Ecuador.
Int J Clin Health Psychol. 2022 Sep-Dec;22(3):100322. doi: 10.1016/j.ijchp.2022.100322. Epub 2022 Jul 20.
BACKGROUND/OBJECTIVE: Depression represents a leading cause of disability and a major contributor to the overall global burden of disease with women systematically reporting a higher prevalence than men. This study aimed to examine the predictive value and relation of three transdiagnostic psychological factors (perceived stress, psychological inflexibility and loneliness) on depression and its sex differences for the general population in a large sample of Ecuador.
A non-probabilistic and non-clinical sample of 16.074 people from across Ecuador were online surveyed using a cross-sectional design. The structural equation model was based on scores from standardized questionnaires as measures of depression, psychological perceived stress, psychological inflexibility, and loneliness.
Women reported significantly higher levels of depression, mediated by differences in perceived stress, psychological inflexibility and loneliness. Perceived stress was the most important predictor of depression and mediated the effect of loneliness on depression. Complementarily, psychological inflexibility partially mediated the effect of perceived stress and loneliness on depression. The overall model accounted for the 78% of the total variance in depression.
Results of this study provide a novel and robust transdiagnostic model of sex differences on depression and insights on how to design effective programs for preventing depression targeting modifiable transdiagnostic risk factors.
背景/目的：抑郁症是导致残疾的主要原因，也是全球疾病总负担的主要促成因素，女性报告的患病率系统性地高于男性。本研究旨在探讨厄瓜多尔一个大样本普通人群中三种跨诊断心理因素（感知压力、心理灵活性和孤独感）对抑郁症的预测价值及关系，以及其性别差异。
采用横断面设计，对来自厄瓜多尔各地的16074人进行非概率性非临床在线调查。结构方程模型基于标准化问卷得分，作为抑郁症、心理感知压力、心理灵活性和孤独感的测量指标。
女性报告的抑郁症水平显著更高，这由感知压力、心理灵活性和孤独感的差异介导。感知压力是抑郁症最重要的预测因素，并介导了孤独感对抑郁症的影响。此外，心理灵活性部分介导了感知压力和孤独感对抑郁症的影响。总体模型解释了抑郁症总变异的78%。
本研究结果提供了一个关于抑郁症性别差异的新颖且稳健的跨诊断模型，并为如何针对可改变的跨诊断风险因素设计有效的抑郁症预防项目提供了见解。
