新冠疫情期间住院精神科患者监护人的抑郁患病率及其与生活质量的关联：基于网络视角

Prevalence of depression and its association with quality of life among guardians of hospitalized psychiatric patients during the COVID-19 pandemic: a network perspective.

作者信息

Zhao Yan-Jie, Zhang Ling, Feng Yuan, Sha Sha, Lam Mei Ieng, Wang Yue-Ying, Li Jia-Xin, Su Zhaohui, Cheung Teris, Ungvari Gabor S, Jackson Todd, An Feng-Rong, Xiang Yu-Tao

机构信息

Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital and the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.

Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Taipa, Macao SAR, China.

出版信息

Front Psychiatry. 2023 May 12;14:1139742. doi: 10.3389/fpsyt.2023.1139742. eCollection 2023.

DOI:10.3389/fpsyt.2023.1139742

PMID:37252144

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10213336/

Abstract

BACKGROUND

The COVID-19 pandemic has greatly affected treatment-seeking behaviors of psychiatric patients and their guardians. Barriers to access of mental health services may contribute to adverse mental health consequences, not only for psychiatric patients, but also for their guardians. This study explored the prevalence of depression and its association with quality of life among guardians of hospitalized psychiatric patients during the COVID-19 pandemic.

METHODS

This multi-center, cross-sectional study was conducted in China. Symptoms of depression and anxiety, fatigue level and quality of life (QOL) of guardians were measured with validated Chinese versions of the Patient Health Questionnaire - 9 (PHQ-9), Generalized Anxiety Disorder Scale - 7 (GAD-7), fatigue numeric rating scale (FNRS), and the first two items of the World Health Organization Quality of Life Questionnaire - brief version (WHOQOL-BREF), respectively. Independent correlates of depression were evaluated using multiple logistic regression analysis. Analysis of covariance (ANCOVA) was used to compare global QOL of depressed versus non-depressed guardians. The network structure of depressive symptoms among guardians was constructed using an extended Bayesian Information Criterion (EBIC) model.

RESULTS

The prevalence of depression among guardians of hospitalized psychiatric patients was 32.4% (95% : 29.7-35.2%). GAD-7 total scores ( = 1.9, 95% : 1.8-2.1) and fatigue ( = 1.2, 95% : 1.1-1.4) were positively correlated with depression among guardians. After controlling for significant correlates of depression, depressed guardians had lower QOL than non-depressed peers did [ = 29.24, < 0.001]. "" (item 4 of the PHQ-9), "" (item 7 of the PHQ-9) and "" (item 2 of the PHQ-9) were the most central symptoms in the network model of depression for guardians.

CONCLUSION

About one third of guardians of hospitalized psychiatric patients reported depression during the COVID-19 pandemic. Poorer QOL was related to having depression in this sample. In light of their emergence as key central symptoms, "," "," and "" are potentially useful targets for mental health services designed to support caregivers of psychiatric patients.

摘要

背景

新冠疫情极大地影响了精神科患者及其监护人寻求治疗的行为。获得心理健康服务的障碍可能会导致不良心理健康后果，不仅对精神科患者如此，对其监护人也是如此。本研究探讨了新冠疫情期间住院精神科患者监护人中抑郁症的患病率及其与生活质量的关联。

方法

本多中心横断面研究在中国开展。分别使用经过验证的中文版患者健康问卷 - 9（PHQ - 9）、广泛性焦虑障碍量表 - 7（GAD - 7）、疲劳数字评定量表（FNRS）以及世界卫生组织生活质量问卷简版（WHOQOL - BREF）的前两项，对监护人的抑郁和焦虑症状、疲劳水平及生活质量（QOL）进行测量。使用多元逻辑回归分析评估抑郁症的独立相关因素。采用协方差分析（ANCOVA）比较抑郁监护人与非抑郁监护人的总体生活质量。使用扩展贝叶斯信息准则（EBIC）模型构建监护人抑郁症状的网络结构。

结果

住院精神科患者监护人中抑郁症的患病率为32.4%（95%可信区间：29.7 - 35.2%）。监护人的GAD - 7总分（β = 1.9，95%可信区间：1.8 - 2.1）和疲劳（β = 1.2，95%可信区间：1.1 - 1.4）与抑郁症呈正相关。在控制抑郁症的显著相关因素后，抑郁监护人的生活质量低于非抑郁同龄人[F(1, 342) = 29.24，P < 0.001]。“（PHQ - 9的第4项）”、“（PHQ - 9的第7项）”和“（PHQ - 9的第2项）”是监护人抑郁症网络模型中最核心的症状。