临床治愈抑郁症患者症状自评在负性自动思维与心理社会功能间的中介作用

Mediating effect of self-evaluation of depressive symptoms on automatic thinking and psychosocial function of patients with depression in remission

目的探讨临床治愈的抑郁症患者的抑郁症状自评在负性自动思维与心理社会功能间的中介作用。方法采用汉密尔顿抑郁量表(HAMD-17)、生活质量综合评定问卷(GQOLI)、贝克抑郁量表(BDI)以及自动思维问卷(ATQ)对住院并经治疗达到临床治愈的122名抑郁症患者进行测评。结果(1)抑郁症状自评与躯体功能、心理功能、社会功能均呈显著负相关(r=-0.559,r=-0.435,r=-0.388,均P<0.01),负性自动思维与躯体功能、心理功能、社会功能水平均呈显著负相关(r=-0.563,r=-0.449,r=-0.468,均P<0.01)。(2)抑郁症状自评低分组躯体功能水平[(70.27±11.33)分]、心理功能水平[(69.54±11.53)分]、社会功能水平[(69.09±10.41)分]均高于抑郁症状自评高分组[(53.33±9.32)分,(57.24±13.80)分,(57.69±12.77)分],差异具有统计学意义(t=7.40,4.82,4.48,P<0.01)。(3)负性自动思维对躯体功能水平具有显著的负向影响(B=-0.17,P<0.01),抑郁症状自评在其中具有部分中介作用;抑郁症状自评在负性自动思维和心理功能水平中也具有中介作用。结论临床治愈的抑郁症患者抑郁症状自评在负性自动思维与躯体功能间起到中介作用,同时也在负性自动思维与心理功能间也起到中介作用。

Objective To investigate the mediating effects of self-evaluation of depressive symptoms between psychosocial function and negative automatic thinking in patients with depression in remission.Methods The Hamilton depression scale(HAMD-17),generic quality of life inventory(GQOLI),Beck depression inventory(BDI)and automatic thoughts questionnaire(ATQ)were applied to 122 subjects who were patients with depression in remission.Results(1)There was significantly negative correlation between self-evaluation of depressive symptoms and physical function and psychological function and social function(r=-0.559,r=-0.435,r=-0.388,all P<0.01),and negative correlation between negative automatic thinking and physical function,psychological function and social function(r=-0.563,r=-0.449,r=-0.468,all P<0.01).(2)The score of physical function,psychological function and social function in the group with low self-evaluation of depressive symptoms was higher than those in the group with high self-evaluation of depressive symptoms(low group: 70.27±11.33,69.54±11.53,69.09±10.41;high group: 53.33±9.32,57.24±13.80,57.69±12.77),and the differences were statistically significant(t=7.40,4.82,4.48,P<0.01).(3)Negative automatic thinking had a significant negative effect on physical function(B=-0.17,P<0.01),which was affected by self-evaluation of depressive symptoms.The relationship between negative automatic thinking and psychological function was affected by self-evaluation of depressive symptoms.Conclusion Self-evaluation of depressive symptom plays a mediating role between negative automatic thinking and physical function,which also was a mediator in the relationship between negative automatic thinking and mental function.