Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China.
Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China.
J Affect Disord. 2023 Feb 1;322:39-45. doi: 10.1016/j.jad.2022.11.028. Epub 2022 Nov 12.
Anxious depression is a common subtype of major depressive disorder (MDD) associated with adverse outcomes and severely impaired social function. The aim of this study was to explore the relationships between child maltreatment, family functioning, social support, interpersonal problems, dysfunctional attitudes, and anxious depression.
Data were collected from 809 MDD patients. The Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale-17 (HAMD-17), Family Assessment Device (FAD), Childhood Trauma Questionnaire (CTQ), Social Support Rating Scale (SSRS), Interpersonal Relationship Integrative Diagnostic Scale (IRIDS), and Dysfunctional Attitudes Scale (DAS) were administered and recorded. Anxious depression was defined as an anxiety/somatization factor score ≥ 7 on the HAMD-17. Chi-squared tests, Mann-Whitney U tests, distance correlations, and structural equation models were used for data analysis.
Two-fifths of MDD patients had comorbid anxiety, and there were significant differences in child maltreatment, family functioning, social support, interpersonal problems, and dysfunctional attitudes between groups. Of these factors, interpersonal relationships were most related to anxiety in MDD patients, and dysfunctional attitudes mediated the relationship between interpersonal relationships and anxiety in MDD patients.
This study used cross-sectional data with no further follow-up to assess patient outcomes. This study did not include information about pharmacological treatments. A larger sample size is needed to validate the results.
Psychosocial factors were significantly associated with anxious depression. Interpersonal relationships and dysfunctional attitudes have a direct effect on anxious depression, and interpersonal relationships also mediate the effects of anxious depression via dysfunctional attitudes.
焦虑型抑郁症是一种常见的重性抑郁障碍（MDD）亚型，与不良结局和严重受损的社会功能有关。本研究旨在探讨儿童期虐待、家庭功能、社会支持、人际关系问题、功能失调态度与焦虑型抑郁症的关系。
本研究共纳入 809 例 MDD 患者。采用汉密尔顿焦虑量表（HAMA）、汉密尔顿抑郁量表-17 项（HAMD-17）、家庭评估量表（FAD）、儿童期创伤问卷（CTQ）、社会支持评定量表（SSRS）、人际关系综合诊断量表（IRIDS）和功能失调态度量表（DAS）进行测评和记录。将 HAMD-17 的焦虑/躯体化因子评分≥7 定义为焦虑型抑郁症。采用卡方检验、Mann-Whitney U 检验、距离相关和结构方程模型进行数据分析。
1/5 的 MDD 患者合并焦虑，且两组间在儿童期虐待、家庭功能、社会支持、人际关系问题和功能失调态度方面存在显著差异。其中，人际关系与 MDD 患者的焦虑最相关，功能失调态度在 MDD 患者的人际关系与焦虑之间起中介作用。
本研究采用横断面数据，无进一步随访评估患者结局。本研究未包括药物治疗信息。需要更大的样本量来验证结果。
心理社会因素与焦虑型抑郁症显著相关。人际关系和功能失调态度对焦虑型抑郁症有直接影响，人际关系还通过功能失调态度对焦虑型抑郁症产生中介作用。
