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抑郁对居丧老年人孤独感与悲伤轨迹之间关系的影响。

The influence of depression on the relationship between loneliness and grief trajectories in bereaved older adults.

作者信息

Reiland Hannah, Banerjee Anjishnu, Claesges Stacy A, Giuca Anne-Marie, Hillard Cecilia J, Reynolds Charles F, Goveas Joseph S

机构信息

Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI.

Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI.

出版信息

Psychiatry Res Commun. 2021 Oct;1(1). doi: 10.1016/j.psycom.2021.100006. Epub 2021 Oct 28.

Abstract

Loneliness is associated with adverse mental health outcomes in older adults. Bereavement triggers intense feelings of loneliness. This pilot study explored the association between baseline loneliness and grief symptom trajectories in bereaved elders and explored if this association is moderated by depressive symptom changes. 56 individuals aged 50 years and older, within 13-months following bereavement, completed assessments. Loneliness was measured at baseline using the UCLA loneliness scale-version 3. Grief and depressive symptoms were measured over 26 weeks using the inventory of complicated grief (ICG) and the 17-item Hamilton Depressive Rating (HAM-D) scales, respectively. Linear regression explored the cross-sectional association between loneliness and grief symptoms, after adjusting for covariates including depressive symptoms. A mixed-effects linear model tested whether baseline loneliness was related to grief symptom trajectory over 26 weeks, after accounting for depressive symptom changes. Loneliness was associated with grief symptom severity at baseline; however, this cross-sectional association was not significant after adjusting for depressive symptoms. Longitudinally, baseline loneliness was positively associated with grief symptom trajectories; however, depressive symptom changes moderated this association. Depressive symptom alterations appear to weaken the loneliness-grief symptom change association. These exploratory findings point to opportunities for interventions targeting loneliness and depression that may reduce grief intensity over time in bereaved elders.

摘要

孤独与老年人不良心理健康结果相关。丧亲之痛会引发强烈的孤独感。这项初步研究探讨了丧亲老年人基线孤独感与悲伤症状轨迹之间的关联,并探讨了这种关联是否会因抑郁症状的变化而受到调节。56名年龄在50岁及以上、处于丧亲后13个月内的个体完成了评估。使用加州大学洛杉矶分校孤独量表第3版在基线时测量孤独感。分别使用复杂悲伤量表(ICG)和17项汉密尔顿抑郁量表(HAM-D)在26周内测量悲伤和抑郁症状。线性回归在调整包括抑郁症状在内的协变量后,探讨了孤独感与悲伤症状之间的横断面关联。一个混合效应线性模型在考虑抑郁症状变化后,测试了基线孤独感是否与26周内的悲伤症状轨迹相关。孤独感与基线时的悲伤症状严重程度相关;然而,在调整抑郁症状后,这种横断面关联并不显著。纵向来看,基线孤独感与悲伤症状轨迹呈正相关;然而,抑郁症状的变化调节了这种关联。抑郁症状的改变似乎削弱了孤独感与悲伤症状变化之间的关联。这些探索性发现指出了针对孤独和抑郁进行干预的机会,这些干预可能会随着时间的推移减轻丧亲老年人的悲伤强度。

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