Philosophy and Social Science Laboratory of Reading and Development in Children and Adolescents (South China Normal University), Ministry of Education, Guangzhou, China; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, China.
Philosophy and Social Science Laboratory of Reading and Development in Children and Adolescents (South China Normal University), Ministry of Education, Guangzhou, China; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, China.
J Affect Disord. 2024 Dec 1;366:172-180. doi: 10.1016/j.jad.2024.08.181. Epub 2024 Aug 28.
Widowhood, as a traumatic event in the aging process, may lead to adverse psychological consequences such as anxiety and depression. However, the heterogeneity of anxiety and depression comorbidity patterns in widowed elderly and the interrelationships between symptoms have not been adequately studied.
10,239 elderly aged 65 years and older were screened from the Chinese Longitudinal Healthy Longevity Survey (CLHLS 2017-2018), to assess depression and anxiety using the Center for Epidemiologic Studies Depression Scale (CESD) and the 7-item Generalized Anxiety Disorder Questionnaire (GAD). The subgroups of widowed elderly with similar patterns of symptoms were identified by latent profile analysis (LPA). The structure of anxiety-depressive comorbidity network was characterized using "bridge expected influence" as centrality indices. Network stability was tested using a case drop bootstrap program. A network comparison test (NCT) was performed to examine the differences in network characteristics across LPA subgroups.
LPA identified dichotomous profiles: low comorbid (n = 4457) and high comorbid (n = 692). NCT revealed a significant difference in the global strength between networks (S = 0.631, p < 0.001). GAD1 (Nervousness or anxiety) is the common bridging symptom for both networks, while the bridging symptom for the high comorbidity network also includes GAD3 (Generalized worry).
Cross-sectional methods are unable to verify causal relationships, and further randomized controlled trials are warranted.
Anxiety-depressive pattern in Chinese widowed elderly can be categorized into a low comorbid or a high comorbid group. GAD3 (Generalized worry) can be used as the core intervention target during intervention.
丧偶作为衰老过程中的创伤性事件，可能导致焦虑和抑郁等不良心理后果。然而，丧偶老年人中焦虑和抑郁共病模式的异质性以及症状之间的相互关系尚未得到充分研究。
从中国长寿纵向研究（CLHLS 2017-2018）中筛选了 10239 名 65 岁及以上的老年人，使用中心流行病学研究抑郁量表（CESD）和 7 项广泛性焦虑症问卷（GAD）评估抑郁和焦虑。采用潜在剖面分析（LPA）识别具有相似症状模式的丧偶老年人亚组。使用“桥梁预期影响”作为中心性指标来描述焦虑抑郁共病网络的结构。通过病例丢弃bootstrap 程序测试网络稳定性。采用网络比较测试（NCT）检验 LPA 亚组之间网络特征的差异。
LPA 确定了两种二分谱：低共病（n=4457）和高共病（n=692）。NCT 显示网络之间的整体强度存在显著差异（S=0.631，p<0.001）。GAD1（紧张或焦虑）是两个网络的共同桥梁症状，而高共病网络的桥梁症状还包括 GAD3（广泛担忧）。
横断面方法无法验证因果关系，需要进一步进行随机对照试验。
中国丧偶老年人的焦虑抑郁模式可分为低共病或高共病组。GAD3（广泛担忧）可作为干预过程中的核心干预靶点。
