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对诊断为重度抑郁症患者的早期适应不良图式和成人依恋模式的评估及其与疾病变量关系的考察。

Evaluation of Early Maladaptive Schemas and Adult Attachment Profiles in Patients Diagnosed with Major Depressive Disorder and Examination of Their Relationship with Disease Variables.

作者信息

Özaslan Emre, Türkili Seda, Acar Şenel

机构信息

Hatay Reyhanlı State Hospital, 31500 Hatay, Turkey.

Faculty of Medicine, Mersin University, 33343 Mersin, Turkey.

出版信息

J Clin Med. 2024 Dec 31;14(1):170. doi: 10.3390/jcm14010170.

Abstract

The study aimed to compare the early maladaptive schemas and adult attachment profiles of patients diagnosed with major depressive disorder with those of healthy controls. Another objective of our study was to investigate the potential relationships between disease-related variables-such as the type of depression, number of depressive episodes, history of hospitalization, and suicidal ideation or attempts-and schema and attachment characteristics in the group of patients with major depressive disorder. The study included 118 patients who presented to the Psychiatry outpatient clinic at Mersin University Faculty of Medicine Hospital between 1 April 2021 and 1 September 2021 and were diagnosed with major depressive disorder according to DSM-5 diagnostic criteria based on mental state examinations conducted by researchers, as well as 92 healthy volunteers with no history of mental disorders. A sociodemographic data form prepared by the researchers was used to inquire about characteristics such as gender, age, and educational status. Additionally, a clinical data form was designed and implemented by the researchers to gather information regarding DSM-5 specifiers and the patients' clinical histories. The Young Schema Questionnaire Short Form-3 was used to evaluate early maladaptive schemas, while adult attachment profiles were assessed using the Experiences in Close Relationships Inventory II. The severity of depression in the patient group was measured with the Beck Depression Inventory. Statistical analysis of the data was conducted using SPSS 21, with a -value less than 0.05 considered statistically significant. The study included 118 patients, 84 (71.2%) of whom were women and 34 (28.8%) men, along with 92 healthy volunteers, 60 (65.2%) of whom were women and 32 (34.8%) men. The mean age was 41.9 (±13.2) in the patient group and 40.8 (±11.9) in the control group ( > 0.05). The patient group had higher scores than the control group across all schema subtypes and attachment dimensions. Significant differences in certain schemas were observed between patients with chronic depression and those with recurrent depressive episodes, as well as between patients with a single hospitalization history and those with multiple hospitalizations, and between patients with a history of suicide attempts and those without any suicidal ideation or attempts. Positive significant correlations were found between the attachment and schema scores and the severity of depression in both patients and controls. Further research is needed to determine the role of schemas and attachment styles in the development of depression in more detail and to focus on schema and attachment-based therapies in treatment.

摘要

该研究旨在比较被诊断为重度抑郁症的患者与健康对照组的早期适应不良图式和成人依恋模式。我们研究的另一个目标是调查重度抑郁症患者组中与疾病相关的变量(如抑郁症类型、抑郁发作次数、住院史以及自杀意念或自杀企图)与图式和依恋特征之间的潜在关系。该研究纳入了2021年4月1日至2021年9月1日期间在梅尔辛大学医学院医院精神科门诊就诊且根据研究人员进行的精神状态检查按照《精神疾病诊断与统计手册》第5版(DSM - 5)诊断标准被诊断为重度抑郁症的118名患者,以及92名无精神疾病史的健康志愿者。研究人员准备的一份社会人口统计学数据表格用于询问性别、年龄和教育程度等特征。此外,研究人员设计并实施了一份临床数据表格,以收集有关DSM - 5诊断说明符和患者临床病史的信息。使用《青少年图式问卷简表 - 3》来评估早期适应不良图式,同时使用《亲密关系经历量表II》评估成人依恋模式。患者组的抑郁严重程度用《贝克抑郁量表》进行测量。使用SPSS 21对数据进行统计分析,p值小于0.05被认为具有统计学意义。该研究包括118名患者,其中84名(71.2%)为女性,34名(28.8%)为男性,以及92名健康志愿者,其中60名(65.2%)为女性,32名(34.8%)为男性。患者组的平均年龄为41.9(±13.2)岁,对照组为40.8(±11.9)岁(p>0.05)。在所有图式亚型和依恋维度上,患者组的得分均高于对照组。在慢性抑郁症患者与复发性抑郁发作患者之间、单次住院史患者与多次住院患者之间以及有自杀未遂史患者与无任何自杀意念或自杀企图患者之间,某些图式存在显著差异。在患者和对照组中,依恋和图式得分与抑郁严重程度之间均发现了显著的正相关。需要进一步的研究来更详细地确定图式和依恋风格在抑郁症发展中的作用,并在治疗中关注基于图式和依恋的疗法。

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本文引用的文献

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Depression: A cognitive perspective.抑郁:认知视角。
Clin Psychol Rev. 2019 Apr;69:51-66. doi: 10.1016/j.cpr.2018.06.008. Epub 2018 Jun 18.
10
Adult attachment representations and depressive symptoms: A meta-analysis.成人依恋表征与抑郁症状:荟萃分析。
J Affect Disord. 2018 Aug 15;236:274-290. doi: 10.1016/j.jad.2018.04.091. Epub 2018 Apr 25.

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