Kazan Joseph, Gerlach Andrew R, Mizuno Akiko, Andreescu Carmen, Aizenstein Howard J, Ward Scott, Buente Kara J, Stahl Sarah T
Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA.
Psychiatry Res Commun. 2023 Mar;3(1). doi: 10.1016/j.psycom.2022.100096. Epub 2022 Dec 20.
This study examined the temporal relationship among depression, anxiety, insomnia, perceived stress, and physical activity in adults aged 60+ years with a history of major depressive disorder. We conducted a longitudinal study with 12 weeks of follow-up. Assessments consisted of phone or video interviews and included questionnaires evaluating depression, anxiety, insomnia, perceived stress, and physical activity. Our analytic approach consisted of a depression-focused cross-lagged panel model (CLPM) to examine week-to-week correlations among the five measures. The depression-focused CLPM identified statistically significant week-to-week self-predictive effects for each of the five measures. Higher depressive symptom burden was a strong predictor of increased stress, greater insomnia, and less physical activity the following week. No other cross-measure predictions were statistically significant. Our analytical approach clarifies the directional relationship among variables that typically co-occur with depression showing that higher depression symptom burden predisposes older adults to poor sleep, a reduced level of daytime activity, and a greater sense of stress. These findings support the need for longitudinal assessments and targeted interventions for reducing symptoms of depression in older adults.
本研究调查了60岁及以上有重度抑郁症病史的成年人中抑郁、焦虑、失眠、感知压力和身体活动之间的时间关系。我们进行了一项为期12周随访的纵向研究。评估包括电话或视频访谈，并包括评估抑郁、焦虑、失眠、感知压力和身体活动的问卷。我们的分析方法包括一个以抑郁为重点的交叉滞后面板模型（CLPM），以检验这五项测量指标之间的周与周相关性。以抑郁为重点的CLPM确定了这五项测量指标中每一项在统计学上具有显著的周与周自我预测效应。较高的抑郁症状负担是下周压力增加、失眠加重和身体活动减少的有力预测指标。没有其他交叉测量预测在统计学上具有显著性。我们的分析方法阐明了通常与抑郁同时出现的变量之间的方向性关系，表明较高的抑郁症状负担使老年人易出现睡眠不佳、白天活动水平降低和更大的压力感。这些发现支持了对老年人进行纵向评估和针对性干预以减轻抑郁症状的必要性。
