Solis Ericka C, Carlier Ingrid V E, Schoevers Robert A, Penninx Brenda W J H, van Hemert Albert M, van der Does A J Willem
Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands.
Department of Psychiatry, University of Groningen, Groningen, The Netherlands.
Int J Psychiatry Clin Pract. 2025 Mar;29(1):32-40. doi: 10.1080/13651501.2025.2476509. Epub 2025 Mar 16.
Cognitive Reactivity (CR) is the (re-)activation of negative cognitions by dysphoric mood. We examined whether CR predicts depressive episodes across 2 and 9 years, beyond subclinical depressive symptoms, neuroticism, and previous depressive episodes.
Participants ( = 1,734) from the Netherlands Study of Depression and Anxiety (NESDA) were never-depressed or remitted-depressed for ≥1 month prior to baseline. We examined 2-year and 9-year predictions using Cox's survival analysis and logistic regression, respectively. Two-year coefficient-based weight-points were calculated and evaluated using ROC analysis.
CR was a statistically-significant predictor of two-year depressive episodes, with an odds ratio of 1.04, 95% CI (1.02-1.06), and over nine years, with an adjusted hazard ratio of 1.01, 95% CI (1.01-1.02). The influence of CR and subclinical depressive symptoms decreased as the number of episodes increased, especially in ≥ 3 past episodes. Calculated weight-points correctly predicted 33.5% of participants who developed 2-year depression, compared to a 17.8% base rate (sensitivity = .81, specificity = .66).
CR is a moderately strong predictor of depressive episodes across 2 and 9 years. In participants with ≥ 3 prior episodes, depression history is such a strong predictor that a ceiling effect occurs, removing any added value of other predictors.
认知反应性（CR）是指烦躁情绪对消极认知的（再）激活。我们研究了CR是否能在2年和9年的时间跨度内预测抑郁发作，且独立于亚临床抑郁症状、神经质和既往抑郁发作。
来自荷兰抑郁与焦虑研究（NESDA）的参与者（n = 1734）在基线前从未抑郁或已缓解抑郁≥1个月。我们分别使用Cox生存分析和逻辑回归来研究2年和9年的预测情况。基于两年系数计算权重分数，并使用ROC分析进行评估。
CR是两年期抑郁发作的统计学显著预测因子，优势比为1.04，95%可信区间（1.02 - 1.06）；在九年的时间跨度内，调整后的风险比为1.01，95%可信区间（1.01 - 1.02）。随着发作次数的增加，CR和亚临床抑郁症状的影响减弱，尤其是在既往发作≥3次的情况下。计算出的权重分数正确预测了33.5%出现2年抑郁的参与者，而基线发生率为17.8%（敏感性 = 0.81，特异性 = 0.66）。
CR是2年和9年抑郁发作的中度强预测因子。在既往发作≥3次的参与者中，抑郁病史是如此强大的预测因子，以至于出现了天花板效应，消除了其他预测因子的任何附加价值。
