Department of Psychiatry, Tokyo Medical University Hachioji Medical Center, Hachioji, Tokyo, Japan.
Department of Psychiatry, Toranomon Hospital, Tokyo, Japan.
PLoS One. 2023 Nov 6;18(11):e0294070. doi: 10.1371/journal.pone.0294070. eCollection 2023.
The influence of psychosocial factors on differentiating between melancholic depression (MEL) and non-melancholic depression (NMEL) remains unclear. In this study, we aimed to investigate the interrelationship between dysfunctional parenting, personality traits, stressful life events, and the diagnosis of MEL and NMEL among patients with major depressive disorder (MDD).
Ninety-eight patients with MDD completed the following self-administered questionnaires: the Parental Bonding Instrument (PBI) for dysfunctional parenting, the short version of the Temperament Evaluation of Memphis, Pisa, Paris and San Diego-autoquestionnaire version (TEMPS-A) for affective temperaments, and the Life Experiences Survey (LES) for stressful life events. The data were analyzed using single and multiple regression analyses and path analysis.
Dysfunctional parenting did not have a significant direct effect on MEL. However, paternal care had a significant indirect effect on MEL through depressive temperament. The total indirect effect of paternal care on MEL was significant (indirect path coefficient = 0.161, p <0.05). In other words, low levels of paternal care were associated with the development of NMEL via increased depressive temperament. None of the paths from paternal care to MEL via negative change scores of the LES were significant.
This study used cross-sectional data, so the possibility that current depressive status may affect the assessment of LES and TEMPS-A cannot be ruled out.
We found that low levels of paternal care did not directly affect the development of NMEL, but affected the development of NMEL through the mediation of depressive temperament rather than stressful life events.
心理社会因素对区分忧郁性抑郁症（MEL）和非忧郁性抑郁症（NMEL）的影响尚不清楚。在这项研究中，我们旨在研究有或无重性抑郁障碍（MDD）的患者中功能失调性养育、人格特质、生活应激事件与 MEL 和 NMEL 诊断之间的相互关系。
98 例 MDD 患者完成了以下自我管理问卷：功能失调养育量表（PBI）、孟菲斯、比萨、巴黎和圣地亚哥-自动问卷（TEMPS-A）的简短版、生活经历量表（LES）。使用单因素和多因素回归分析和路径分析对数据进行分析。
功能失调的养育对 MEL 没有显著的直接影响。然而，父亲的关怀对 MEL 有显著的间接影响，通过抑郁气质。父亲关怀对 MEL 的总间接效应显著（间接路径系数=0.161，p<0.05）。换句话说，低水平的父爱与 NMEL 的发展有关，通过增加抑郁气质。父亲关怀对 MEL 的所有路径都没有通过 LES 的负面变化分数呈显著。
本研究采用了横断面数据，因此目前的抑郁状态可能会影响 LES 和 TEMPS-A 的评估，这一点不能排除。
我们发现，低水平的父爱并不直接影响 NMEL 的发展，而是通过抑郁气质的中介作用而不是生活应激事件来影响 NMEL 的发展。
