Cumulative effects of stress-sensitivity factors on depressive symptoms and suicide risk: A prospective study.

IF 3.9 4区 医学 Q1 PSYCHIATRY
Xue-Mei Qin, Meng-Qi Xu, Ya-Qi Qin, Fang-Zhou Shao, Mo-Han Ma, Wen-Wen Ou, Guan-Yi Lv, Qian-Qian Zhang, Wen-Tao Chen, Xiao-Tian Zhao, Ao-Qian Deng, Jin-Tao Xiong, Ling-Si Zeng, Yi-Lin Peng, Mei Huang, Shu-Yin Xu, Mei Liao, Li Zhang, Ling-Jiang Li, Yu-Meng Ju, Jin Liu, Bang-Shan Liu, Yan Zhang
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引用次数: 0

Abstract

Background: Sensitivity to stress is essential in the onset, clinical symptoms, course, and prognosis of major depressive disorder (MDD). Meanwhile, it was unclear how variously classified but connected stress-sensitivity variables affect MDD. We hypothesize that high-level trait- and state-related stress-sensitivity factors may have different cumulative effects on the clinical symptoms and follow-up outcomes of MDD.

Aim: To investigate how stress-sensitivity factors added up and affected MDD clinical symptoms and follow-up results.

Methods: In this prospective study, 281 MDD patients were enrolled from a tertiary care setting. High-level stress-sensitivity factors were classified as trait anxiety, state anxiety, perceived stress, and neuroticism, with a total score in the top quartile of the research cohort. The cumulative effects of stress-sensitivity factors on cognitive dysfunction, disability and functional impairment, suicide risk, and depressive and anxiety symptoms were examined using an analysis of variance with linear trend analysis. Correlations were investigated further using multiple regression analysis.

Results: Regarding high-level stress-sensitivity factors, 53.40% of patients had at least one at baseline, and 29.61% had two or more. Four high-level stress-sensitivity components had significant cumulative impacts on MDD symptoms at baseline (all P < 0.001). Perceived stress predicted the greatest effect sizes of state-related factors on depressive symptoms (partial η 2 = 0.153; standardized β = 0.195; P < 0.05). The follow-up outcomes were significantly impacted only by the high-level trait-related components, mainly when it came to depressive symptoms and suicide risk, which were predicted by trait anxiety and neuroticism, respectively (partial η 2 = 0.204 and 0.156; standardized β = 0.247 and 0.392; P < 0.05).

Conclusion: To enhance outcomes of MDD and lower the suicide risk, screening for stress-sensitivity factors and considering multifaceted measures, mainly focusing on trait-related ones, should be addressed clinically.

压力敏感因素对抑郁症状和自杀风险的累积效应:一项前瞻性研究。
背景:应激敏感性在重度抑郁障碍(MDD)的发病、临床症状、病程和预后中都是必不可少的。与此同时,还不清楚各种分类但相互关联的压力敏感性变量如何影响重度抑郁症。我们假设高水平的特质和状态相关的应激敏感因素可能对重度抑郁症的临床症状和随访结果有不同的累积效应。目的:探讨应激敏感因素对重度抑郁症临床症状及随访结果的影响。方法:在这项前瞻性研究中,281名重度抑郁症患者从三级医疗机构入组。高水平的压力敏感因素被分类为特质焦虑、状态焦虑、感知压力和神经质,总分在研究队列的前四分之一。采用线性趋势分析的方差分析,考察应激敏感因素对认知功能障碍、残疾和功能障碍、自杀风险、抑郁和焦虑症状的累积影响。使用多元回归分析进一步研究相关性。结果:在高水平应激敏感因素方面,53.40%的患者基线时至少有一种,29.61%的患者基线时有两种及以上。四种高水平应激敏感成分在基线时对重度抑郁症症状有显著的累积影响(均P < 0.001)。感知压力对状态相关因素对抑郁症状的影响最大(部分η 2 = 0.153;标准化β = 0.195;P < 0.05)。随访结果仅受到高水平特质相关成分的显著影响,主要是抑郁症状和自杀风险,这两项分别由特质焦虑和神经质预测(部分η 2 = 0.204和0.156;标准化β = 0.247和0.392;P < 0.05)。结论:临床应注重筛查应激敏感因素,并考虑多方面措施,以特质相关因素为重点,提高重度抑郁症的治疗效果,降低自杀风险。
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来源期刊
自引率
6.50%
发文量
110
期刊介绍: The World Journal of Psychiatry (WJP) is a high-quality, peer reviewed, open-access journal. The primary task of WJP is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of psychiatry. In order to promote productive academic communication, the peer review process for the WJP is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJP are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in psychiatry.
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