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反刍思维在精神分裂症患者童年创伤与抑郁症状之间起中介作用。

Rumination mediates the relationship between childhood trauma and depressive symptoms in schizophrenia patients.

机构信息

Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, People's Republic of China.

Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.

出版信息

Eur Arch Psychiatry Clin Neurosci. 2023 Aug;273(5):1085-1094. doi: 10.1007/s00406-022-01525-2. Epub 2022 Dec 9.

Abstract

Rumination and childhood trauma are related to depressive symptoms in clinical and non-clinical individuals. This is the first study aimed to test the mediating effect of rumination on the relationship between childhood trauma and depressive symptoms in schizophrenia patients. A total of 313 schizophrenia patients were recruited in the present study. The 17-item Hamilton Depression Rating Scale (HAMD-17) was adopted to evaluate depressive symptoms, the short-form Childhood Trauma Questionnaire (CTQ-SF) and the 10-item Ruminative response scale (RRS-10) were utilized to assess the childhood trauma and rumination in patients, respectively. Our results showed that 168 schizophrenia patients (53.67%) had comorbid depressive symptoms. These patients with depressive symptoms had higher levels of childhood trauma [both CTQ-SF total scores and emotional abuse (EA), emotional neglect (EN), physical neglect (PN) subscale scores] and rumination (both RRS-10 total scores and brooding, reflection subscale scores) compared to patients without depressive symptoms. The stepwise logistic regression analysis identified that EN (OR 1.196, P = 0.003), PN (OR 1.1294, P < 0.001), brooding (OR 1.291, P < 0.001) and reflection (OR 1.481, P < 0.001) could independently predict the depressive symptoms in schizophrenia patients. Moreover, RRS-10 and its subscale scores could mediate the relationship between depressive symptoms and childhood trauma, especially EA, EN and PN in schizophrenia. Our preliminary findings suggest that the rigorous assessment and psychosocial interventions of rumination are important to alleviate the influence of childhood trauma on depressive symptoms in schizophrenia patients.

摘要

反刍和童年创伤与临床和非临床个体的抑郁症状有关。这是第一项旨在测试反刍对精神分裂症患者童年创伤与抑郁症状之间关系的中介作用的研究。本研究共招募了 313 名精神分裂症患者。采用 17 项汉密尔顿抑郁评定量表(HAMD-17)评估抑郁症状,采用简短版童年创伤问卷(CTQ-SF)和 10 项反刍反应量表(RRS-10)评估患者的童年创伤和反刍情况。我们的结果显示,313 名精神分裂症患者中有 168 名(53.67%)存在共病抑郁症状。这些有抑郁症状的患者的童年创伤程度更高[CTQ-SF 总分和情感虐待(EA)、情感忽视(EN)、身体忽视(PN)分量表得分]和反刍程度更高[RRS-10 总分和沉思、反省分量表得分],而没有抑郁症状的患者则较低。逐步逻辑回归分析确定,EN(OR 1.196,P=0.003)、PN(OR 1.1294,P<0.001)、沉思(OR 1.291,P<0.001)和反省(OR 1.481,P<0.001)可以独立预测精神分裂症患者的抑郁症状。此外,RRS-10 及其分量表得分可以介导抑郁症状与童年创伤之间的关系,尤其是 EA、EN 和 PN 在精神分裂症中的关系。我们的初步研究结果表明,对反刍的严格评估和心理社会干预对于减轻童年创伤对精神分裂症患者抑郁症状的影响很重要。

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