The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China.
Xuzhou Oriental People's Hospital, Xuzhou 221004, China.
J Affect Disord. 2024 Dec 15;367:219-228. doi: 10.1016/j.jad.2024.08.210. Epub 2024 Sep 1.
Enhancing psychosocial functioning is crucial for reducing relapse in depression, but methods for monitoring and recovery are unclear.
A 1-year follow-up study assessed psychosocial functioning in 182 patients with remitted depression at baseline (T0) as well as at 1, 2, 6, 9, and 12 months post-remission (T1-T5). Using generalized estimating equations (GEE) and multiple linear regression (MLR), we analyzed the impact of changes in psychosocial functioning on relapse/recurrence risk, and assessed the influence of various factors.
An increase in psychosocial functioning significantly lowered relapse/recurrence odds by 54.2 %, averaging a risk reduction of 3.1 %. GEE analyses indicated subjective depressive symptoms (β = -0.315) most significantly impacted psychosocial functioning, followed by social support (β = 0.236), positive coping (β = 0.225), and negative automatic thoughts (β = -0.183). Negative coping and expressed emotion exhibited non-significant effects. MLR revealed that the impact of negative automatic thoughts was most significant at initial remission, but the relative importance of residual subjective depressive symptoms, positive coping, and social support on psychosocial functioning remained stable over time.
Predetermined follow-up assessments may not fully capture psychosocial functioning at relapse/recurrence, and the inclusion of factors might not be sufficiently comprehensive.
Recovery of psychosocial functioning significantly reduces relapse risk in post-remission patients with depression more than residual subjective depressive symptoms. The degree of influence of factors on psychosocial functioning can change with the length of remission time.
增强心理社会功能对于降低抑郁症的复发至关重要，但监测和康复方法尚不清楚。
一项为期 1 年的随访研究评估了基线（T0）时缓解期抑郁症患者的心理社会功能，以及缓解后 1、2、6、9 和 12 个月（T1-T5）。使用广义估计方程（GEE）和多元线性回归（MLR），我们分析了心理社会功能变化对复发/再发风险的影响，并评估了各种因素的影响。
心理社会功能的提高显著降低了复发/再发的可能性，平均风险降低了 3.1%。GEE 分析表明，主观抑郁症状（β=-0.315）对心理社会功能的影响最为显著，其次是社会支持（β=0.236）、积极应对（β=0.225）和消极自动思维（β=-0.183）。消极应对和表达情感表现出非显著影响。MLR 显示，消极自动思维的影响在初始缓解时最为显著，但残留的主观抑郁症状、积极应对和社会支持对心理社会功能的影响在时间上保持稳定。
预定的随访评估可能无法充分捕捉复发/再发时的心理社会功能，纳入的因素可能不够全面。
在缓解后的抑郁症患者中，心理社会功能的恢复比残留的主观抑郁症状更能显著降低复发风险。各因素对心理社会功能的影响程度会随着缓解时间的延长而发生变化。
