Hudson Georgie, Fung Catherine, Sureshkumar Diliniya Stanislaus, Gómez-Restrepo Carlos, Uribe-Restrepo José Miguel, Ariza-Salazar Karen, Diez-Canseco Francisco, Hidalgo-Padilla Liliana, Toyama Mauricio, Brusco Luis Ignacio, Olivar Natividad, Lucchetti Santiago, Priebe Stefan, Kirkbride James B
Division of Psychiatry, UCL, London, UK
Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK.
BMJ Ment Health. 2025 Jan 9;28(1):e301087. doi: 10.1136/bmjment-2024-301087.
Stressful life events (SLEs) are associated with increased risk of depression or anxiety. Coping mechanisms may moderate this relationship but little is known on this topic in young people or in Latin America.
To investigate whether coping strategies predict odds of depression and/or anxiety and moderate the relationship between SLEs and depression and/or anxiety in young people in Peru, Lima and Bogotá.
Using case-control data from people aged 15-24, we used logistic regression to examine associations between coping mechanism, SLEs and caseness for depression or anxiety, adjusting for sociodemographic and socioeconomic factors. We included interaction terms to model whether this association varied depending on coping mechanisms (positive cognitive restructuring, problem focused, support seeking, distraction, avoidant).
We included 1437 cases and 965 controls. Cases reported less use of positive cognitive restructuring (OR 0.66; 95% CI 0.57 to 0.75) and problem-focused coping (OR 0.82; 95% CI 0.73 to 0.93), and more use of avoidance than controls (OR 1.33; 95% CI 1.19 to 1.50) in adjusted models. They had greater odds of reporting lifetime (OR 1.07; 95% CI 1.04 to 1.10) and past-year (OR 1.05; 95% CI 1.01 to 1.10) SLEs than controls. We found weak but consistent evidence of effect modification; the association between lifetime SLEs and case-control status was stronger in those who used less support seeking (p=0.09), problem-focused coping (p=0.08) or positive cognitive restructuring (p=0.09).
Relationships between SLEs, coping mechanisms and depression/anxiety appear similar in these Latin American cities to other contexts. Active coping strategies may ameliorate the impact of SLEs on mental health of young people.
应激性生活事件（SLEs）与抑郁或焦虑风险增加相关。应对机制可能会调节这种关系，但在年轻人或拉丁美洲，关于这一主题的了解甚少。
调查应对策略是否能预测秘鲁利马和波哥大年轻人抑郁和/或焦虑的几率，并调节SLEs与抑郁和/或焦虑之间的关系。
利用15 - 24岁人群的病例对照数据，我们使用逻辑回归来检验应对机制、SLEs与抑郁或焦虑病例状态之间的关联，并对社会人口学和社会经济因素进行调整。我们纳入了交互项，以模拟这种关联是否因应对机制（积极认知重构、问题聚焦、寻求支持、分心、回避）而异。
我们纳入了1437例病例和965例对照。在调整模型中，病例报告较少使用积极认知重构（比值比0.66；95%置信区间0.57至0.75）和问题聚焦应对（比值比0.82；95%置信区间0.73至0.93），且比对照更多地使用回避策略（比值比1.33；95%置信区间1.19至1.50）。他们报告终生（比值比1.07；95%置信区间1.04至1.10）和过去一年（比值比1.05；95%置信区间1.01至1.10）SLEs的几率高于对照。我们发现了微弱但一致的效应修饰证据；在较少使用寻求支持（p = 0.09）、问题聚焦应对（p = 0.08）或积极认知重构（p = 0.09）的人群中，终生SLEs与病例对照状态之间的关联更强。
在这些拉丁美洲城市，SLEs、应对机制与抑郁/焦虑之间的关系在其他背景下似乎相似。积极的应对策略可能会减轻SLEs对年轻人心理健康的影响。
