抑郁症患者的积极情绪状况及与应对方式和社会支持的关系

目的了解抑郁症患者的积极情绪、特质应对方式和社会支持状况。方法采用方便取样法对天津安定医院14例抑郁症住院患者和18例健康人分别进行正性负性情绪量表(PANAS)、特质应对方式问卷(TCSQ)和领悟社会支持(PSSS)的评估。结果抑郁组积极情绪、积极应对方式和领悟社会支持低于对照组,差异有统计学意义(t=-5.53,P0.01;t=-3.76,P0.01;t=-2.35,P0.05),抑郁组消极应对方式高于对照组,差异有统计学意义(t=1.15,P0.05)。抑郁患者的积极情绪和积极应对方式存在相关,有统计学意义(r=0.54,P0.05)。结论抑郁症患者的积极情绪和积极应对方式较少,感到较少的社会支持。抑郁症患者的积极情绪和积极应对方式相关。     

The relationship of social setting to major depression

ABSTRACT– Sixty middle-aged women with a major depressive episode diagnosed in a community survey were compared with those 400 participants of the study who had no history of major depression. The husbands income and the family income were lower in the depressed group even when adjustment was made for age and marital status. The depressives were more often divorced or widowed than were controls. As a direct consequence of this, women with major depression lived in smaller residences and were more seldom owners of a summerhouse. The proportions of women working full-time, part-time or not working outside home were the same in those with major depression and the controls. The level of adversity (life events and long-term major difficulties) during the year preceding the study was increased in the depressed group when adjustment was made for age, marital status and social class differences. A larger proportion of the depressed women reported marital and job dissatisfaction. Variables reflecting social isolation did not differ between groups. There were no differences between depressed and undepressed regarding churchgoing, but fewer of the former stated that they believed in God.     

The relationship between social support and major depression: cross-sectional, longitudinal, and genetic perspectives

Although social support (SS) is associated with risk for major depression (MD), we are uncertain of the extent to which a) low SS increases risk for MD, b) MD lowers SS, or c) both variables reflect a common genetic liability. Using two waves of interview data on female twin pairs from a population-based registry, we examine the cross-sectional and longitudinal association of eight dimensions of perceived SS and MD. Risk for MD in the last year was inversely associated with supportive spouse and relative relationships, and directly associated with problems in these relationships (e.g., too many demands, criticism, tension, and disagreements). Significant cross-time associations were seen only for spousal variables. The history of MD in one twin significantly predicted low relative and spouse support, and relative and friend problems, in her co-twin (MZ > DZ pairs). The relationship between SS and MD in women is complex and due to at least the three separate mechanisms outlined above that operate to varying degrees in different dimensions of SS.     

Impact of stressful life events, depression, social support, coping, and cortisol on progression to AIDS

OBJECTIVE: This study examined prospectively the effects of stressful events, depressive symptoms, social support, coping methods, and cortisol levels on progression of HIV-1 infection. METHOD: Eighty-two homosexual men with HIV type-1 infection without AIDS or symptoms at baseline were studied every 6 months for up to 7. 5 years. Men were recruited from rural and urban areas in North Carolina, and none was using antiretroviral medications at entry. Disease progression was defined as CD4(+) lymphocyte count <200/microl or the presence of an AIDS indicator condition. RESULTS: Cox regression models with time-dependent covariates were used adjusting for race, baseline CD4(+) count and viral load, and cumulative average antiretroviral medications. Faster progression to AIDS was associated with higher cumulative average stressful life events, coping by means of denial, and higher serum cortisol as well as with lower cumulative average satisfaction with social support. Other background (e.g., age, education) and health habit variables (e.g., tobacco use, risky sexual behavior) did not significantly predict disease progression. The risk of AIDS was approximately doubled for every 1.5-unit decrease in cumulative average support satisfaction and for every cumulative average increase of one severe stressor, one unit of denial, and 5 mg/dl of cortisol. CONCLUSIONS: Further research is needed to determine if treatments based on these findings might alter the clinical course of HIV-1 infection.     

社区独居老人的抑郁状况与社会支持、应对方式和自我效能的相关性分析

目的:探讨社区独居老人社会支持、应对方式、自我效能与抑郁状况的关系。方法:随机抽取虹口区1个街道(广中街道),分别以老年抑郁量表、领悟社会支持量表、应对方式问卷和自我效能量表调查社区独居老人(n=1 033)的抑郁状况、社会支持、应对方式和自我效能。结果:不同年龄、性别、文化程度及抑郁状况的独居老人社会支持、应对方式与自我效能的差异有统计学意义(P0.05)。独居老人的抑郁和自我效能、问题解决应对方式、求助应对方式、朋友支持和其他支持呈负相关,与退避应对方式、自责应对方式和幻想应对方式呈正相关(P0.05)。结论:独居老人的抑郁状况和应对方式及自我效能密切相关。     

The effects of depression, stressful life events, social support, and coping on the progression of HIV infection

This article reviews recent findings concerning the role of psychosocial factors on the progression of HIV. Specifically, we examine the role of depression, stressful life events, social support, and coping on changes in CD4 T-lymphocytes and other indicators of HIV disease progression. Studies have yielded important evidence that depression, stressful life events, low social support, and denial coping may have a detrimental impact on HIV disease course. Delineating the role of psychosocial factors on HIV disease progression may aid in the development of new interventions for this devastating disease.     

抑郁症患者生活事件、特质应对方式、父母养育方式及社会支持情况研究

目的了解抑郁症患者生活事件、特质应对方式、父母养育方式及社会支持状况及其性别差异。方法选取符合《国际疾病分类(第10版)》(ICD-10)抑郁症诊断标准的天津市精神卫生中心2013年3月-2014年2月门诊和住院患者104例,在社区中选取与所调查抑郁症患者社会人口学特征较为接近且汉密尔顿抑郁量表(HAMD-24)评分8分的健康人106例作为对照组;对两组进行生活事件(LES)、特质应对方式(TCSQ)、父母教养方式(EMBU)及社会支持(SSRS)量表测评。结果抑郁症患者负性刺激量、积极应对方式、父亲处罚严厉、母亲处罚严厉、母亲拒绝否认因子评分与对照组比较[(29.96±11.81)vs.(15.00±9.81),(29.31±5.39)vs.(25.36±5.00),(14.69±4.11)vs.(18.41±10.29),(10.23±2.69)vs.(12.34±4.39),(10.02±2.29)vs.(12.64±4.13)],差异有统计学意义(t=-5.699~9.976,P均0.01)。男性抑郁症患者的积极、消极应对方式及社会支持的总得分均高于女性(P0.05)。结论 1抑郁症患者经历更多的负性生活事件并多采用积极应对方式;2父母亲的教育方式均表现为低处罚严厉、低拒绝否认,母亲还表现为低过度保护;3抑郁症患者的客观社会支持较多、主观社会支持较少;4男性比女性抑郁症患者采用更多的积极应对方式和消极应对方式,并有更多的社会支持。     

抑郁症患者总体幸福感与社会支持和应对方式的相关性

目的调查抑郁症患者的幸福感,探讨其总体幸福感与社会支持和应对方式的相关性。方法于2019年2月-9月在安徽省精神卫生中心焦虑抑郁科门诊及住院患者中选择120例符合《国际疾病分类(第10版)》(ICD-10)抑郁症诊断标准的抑郁症患者作为抑郁症组,同时从社区人员及患者家属中选择122例作为对照组。采用总体幸福感量表(GWB)(中国版)、社会支持评定量表(SSRS)、简易应对方式问卷(SCSQ)进行评定,应用Pearson相关分析及多元线性回归分析比较抑郁症患者GWB、SSRS与SCSQ评分的相关性。结果抑郁症患者GWB评分低于对照组,差异有统计学意义[(62.43±13.48)分vs.(84.97±10.02)分,t=-14.780,P<0.01];抑郁症患者GWB评分与SCSQ总评分和积极应对方式评分均呈正相关(r=0.378、0.460,P均<0.01);抑郁症患者GWB评分与SSRS客观支持、主观支持、对支持的利用度评分及总评分均呈正相关(r=0.354~0.561,P<0.05或0.01);SSRS客观支持、主观支持、对支持的利用度评分及总评分与SCSQ总评分和积极应对方式评分均呈正相关(r=0.234~0.398,P<0.05或0.01)。结论抑郁症患者幸福感较低,且其幸福感水平与社会支持和积极应对方式相关。     

The relationship between social support and depression in adolescents

In a non-clinical, adolescent sample, this correlational study tested the hypothesis that there will be an inverse correlation between perceived social support and depression. This hypothesis is consistent with the theoretical literature. The results suggest that perceived social support is associated with depression in adolescents.     

The relationship of social support,social networks and negative events with depression in patients with coronary artery disease

This study examined the relationship of social relationships and negative life events with major depression among 335 inpatients with coronary artery disease (CAD) who were free of neurological illnesses. Depression was assessed using the Duke Depression Evaluation Schedule, a structured psychiatric interview which included the Diagnostic Interview Schedule depression sub-scale, two scales for measuring instrumental and self-maintenance activities of daily living, a measure of negative events and four dimensions of social support. Twenty-seven subjects met DSM-IV criteria for major depression. Examination of the bivariate relationships indicated that being younger, having at least one problem with an ADL and/or one IADL, being non-white, experiencing a greater number of negative events, lack of perceived social support and a lack of social interactions were significantly related to an increased likelihood of being depressed. In multivariate analyses depressed subjects were significantly more likely to report a greater number of negative events than non-depressed individuals after adjusting for sociodemographic and ADL measures. A lack of perceived social support and increased number of negative events increased the likelihood of reporting major depressive symptoms among CAD patients. Understanding the causes of depression in CAD patients may have clinical utility in that reduction in depression may lead to a decreased risk of future CAD events.     

The relationship between social support in pregnancy and postnatal depression

Social Psychiatry and Psychiatric Epidemiology - Lack of social support is considered a potential risk factor for postnatal depression but limited longitudinal evidence is available. Pregnancy,...     

Five-year trajectories of social networks and social support in older adults with major depression

BACKGROUND: Research with nondepressed adults suggests that social networks and social support are stable over the life course until very late age. This may not hold true for older adults with depression. We examined baseline status and trajectories of social networks and social support at the group and individual levels over five years. METHODS: The sample consisted of 339 initially depressed adults aged 59 or older (M = 69 years) enrolled in a naturalistic study of depression. Measures of social ties, including social network size, frequency of interaction, instrumental support, and subjective support, were administered at baseline and yearly for five years. RESULTS: Latent growth curve models were estimated for each aspect of social ties. On average, social network size and frequency of interaction were low at baseline and remained stable over time, whereas subjective and instrumental support were high at baseline yet increased over time. There was significant variation in the direction and rate of change over time, which was not predicted by demographic or clinical factors. CONCLUSIONS: Because increasing social networks may be ineffective and may not be possible for a portion of people who already receive maximal support, interventions to increase social support may only work for a portion of older depressed adults.     

Negative life events, social support and gender difference in depression

Objective

To explore if differences in negative life events, vulnerability and social support may explain the gender difference in depression.

Methods

Cross-sectional, multinational, community survey from five European countries (n = 8,787). Depression is measured by Beck Depression Inventory, whereas negative life events and social support are measured by various questionnaires.

Results

Women report slightly more negative life events than men do, mainly related to the social network, but more social support in general and in connection with reported life events. This trend is the same in all participating countries except Spain, where there is no gender difference in the reported support. In general, women are not more vulnerable to negative life events than men are. However, women with no social support, who are exposed to life events, are more vulnerable than men without support.

Conclusion

The higher rate of depression in women is not explained by gender differences in negative life events, social support or vulnerability.     

The hypothalamic-pituitary-adrenal axis in the perinatal period: Its relationship with major depressive disorder and early life adversity

Abstract

Objectives: Effects of major depressive disorder and early life adversity (ELA) on the maternal HPA axis in the perinatal period were examined.

Methods: Four groups of women (n?=?127) were recruited, with the perinatal groups being compared during pregnancy (Preg) and at two months postpartum (PP) – [1] Depressed during pregnancy (Depressed-Preg/PP), [2] Prior history of depression but euthymic during pregnancy (History-Preg/PP), [3] Healthy pregnant women (Control-Preg/PP), and [4] Healthy non-pregnant women (Non-pregnant Control). Serial saliva samples were collected over the course of a day and waking and evening cortisol, total cortisol output and the cortisol awakening response were examined.

Results: There were no HPA axis differences among the three groups during pregnancy. A history of ELA, regardless of comorbid depression, was associated with higher evening cortisol levels during pregnancy (p?=?0.015). Women in the Depressed-PP group had had higher evening cortisol levels compared to the History-PP group (p?<?0.017).

Conclusions: Evening cortisol measures are a potential marker for both ELA and depression, with higher levels during pregnancy being associated with ELA and higher levels postpartum being associated with antenatal depression.     

Anxiety symptoms in African-American and Caucasian youth: relations to negative life events, social support, and coping

The purpose of the present study was to determine the relations among negative life events, social support, coping and anxiety symptoms in 709 Caucasian and African-American youth between 11 and 14 years of age. Results indicated that more negative life events, less social support, more coping efforts, and African-American status were related to more anxiety symptoms. Additionally, although active coping moderated the relationship between negative life events and anxiety, these relations were qualified in separate analyses for the African-American and Caucasian youth. Negative life events were related to anxiety symptoms only for the African-American participants. When these findings were explored further for males and females of each racial group, negative life events remained significant for African-American males but not African-American females. Implications of these findings are examined and future directions for research to understand the processes underlying these relations with both Caucasian and African-American youth are addressed.     

Pilot study of enhanced social support with automated telephone monitoring after psychiatric hospitalization for depression

Background

Following discharge, patients hospitalized for depression are at high risk for poor retention in outpatient care and adverse outcomes.

Aims

Pilot tests a post-hospital monitoring and enhanced support program for depression.

Method

48 patients at a Veterans Affairs Medical Center discharged following a depression-related inpatient stay received weekly visits or phone calls for 6 months from their choice of either a family member/friend (n = 19) or a certified peer support specialist (n = 29). Participants also completed weekly automated telephone monitoring calls assessing depressive symptoms and antidepressant medication adherence.

Results

Over 90% of participants were more satisfied with their care due to the service. The mean change from baseline to 6 months in depression symptoms was ?7.9 (p < 0.05) according to the Patient Health Questionnaire and ?11.2 (p < 0.05) according to the Beck Depression Inventory-II for those supported by a family member/friend, whereas those supported by a peer specialist had mean changes of ?3.5 (p < 0.05) and ?1.7 (p > 0.10), respectively.

Conclusions

Increased contact with a chosen support person coupled with automated telephone monitoring after psychiatric hospitalization is an acceptable service for patients with depression. Those who received the service, and particularly those supported by a family member/friend, experienced reductions in symptoms of depression.

     

Causal relationship between stressful life events and the onset of major depression.

OBJECTIVE: Stressful life events are associated with the onset of episodes of major depression. However, exposure to stressful life events is influenced by genetic factors, and these factors are correlated with those that predispose to major depression. The aim of this study was to clarify the degree to which stressful life events cause major depression. METHOD: The authors assessed the occurrence of 15 classes of stressful life events and the onset of DSM-III-R major depression over a 1-year period in female twins ascertained from a population-based registry. The sample contained 24,648 person-months and 316 onsets of major depression. Stressful life events were individually rated on contextual threat and dependence (the degree to which the stressful life event could have resulted from the respondent's behavior). The nature of the relationship between stressful life events and major depression was tested by 1) discrete-time survival analysis examining the relationship between dependence and the depressogenic effect of stressful life events and 2) a co-twin control analysis. RESULTS: While independent stressful life events were significantly associated with onsets of depression, when level of threat was controlled, the association was significantly stronger for dependent events. The odds ratio for onset of major depression in the month of a stressful life event was 5.64 in all subjects, 4.52 within dizygotic pairs, and 3.58 within monozygotic pairs. CONCLUSIONS: Stressful life events have a substantial causal relationship with the onset of episodes of major depression. However, about one-third of the association between stressful life events and onsets of depression is noncausal, since individuals predisposed to major depression select themselves into high-risk environments.     

Psychosis proneness, coping, and perceptions of social support

The current study examined coping styles and perceived levels of social support in hypothetically psychosis-prone individuals. Results suggest that psychosis-prone individuals did not differ from a comparison group on levels of adaptive coping or positive social support but that they did endorse higher rates of nonadaptive coping and negative social support compared with the comparison group.