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网络分析痴呆患者照顾者伴发抑郁和焦虑症状的共病情况。

Network Analysis of Comorbid Depressive and Anxious Symptoms in Family Caregivers of People with Dementia.

机构信息

Departamento de Psicología Biológica y de la Salud, Universidad Autónoma de Madrid, Madrid, Spain.

Universidad Rey Juan Carlos, Departamento de Psicología, Madrid, Spain.

出版信息

Clin Gerontol. 2024 Jan-Dec;47(2):244-256. doi: 10.1080/07317115.2023.2217162. Epub 2023 May 25.

Abstract

OBJECTIVES

The aim of this study is an in-depth approach to depressive-anxious comorbidity in caregivers according to stress reactivity to disruptive behaviors using network analysis.

METHODS

The sample was composed of 317 primary family caregivers recruited through Day Care Centers and Neurology Services. The sample was split into low and high stress reactivity groups, based on their reports of reaction to disruptive behaviors. Depressive and anxious symptoms, daily hours dedicated to caregiving, time of caring, frequency of disruptive behaviors, co-residence, and kinship were also cross-sectionally measured.

RESULTS

The sample had a mean age of 62.38 years (SD = 12.97) and 68.5% were women. Regarding the network analysis, while the low reactivity group presents a sparse network, with no connection between anxious and depressive symptoms, the high reactivity group shows a high connection of intra and intercategory symptoms, with apathy, sadness, feeling depressed, and tension being the bridge symptoms between disorders.

CONCLUSIONS

Caregivers' stress reaction to disruptive behaviors might be a key factor for understanding comorbidity between depressive and anxious symptoms.

CLINICAL IMPLICATIONS

Tension, apathy, sadness, and feeling depressed should be clinical targets in the interventions, as they act as bridge symptoms between anxious and depressive symptomatology.

摘要

目的

本研究旨在通过网络分析深入探讨照顾者在应激反应性对破坏性行为方面的抑郁焦虑共病情况。

方法

该样本由通过日间护理中心和神经科服务招募的 317 名主要家庭照顾者组成。根据他们对破坏性行为的反应报告,将样本分为低应激反应组和高应激反应组。抑郁和焦虑症状、每天用于护理的时间、护理时间、破坏性行为的频率、共同居住和亲属关系也进行了横断面测量。

结果

该样本的平均年龄为 62.38 岁(SD=12.97),68.5%为女性。关于网络分析,低反应组的网络稀疏,焦虑和抑郁症状之间没有联系,而高反应组的症状内和症状间的连接较高,冷漠、悲伤、抑郁和紧张是障碍之间的桥梁症状。

结论

照顾者对破坏性行为的应激反应可能是理解抑郁和焦虑症状共病的关键因素。

临床意义

紧张、冷漠、悲伤和抑郁感应成为干预的临床目标,因为它们是焦虑和抑郁症状之间的桥梁症状。

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