精神科门诊患者抑郁和焦虑症状的关系:基于网络分析的方法

Network analysis of depressive and dysphoric symptom relationships in psychiatric outpatients

目的本研究以精神科门诊患者为研究对象,探索其抑郁和焦虑症状网络。方法使用某综合医院心身科门诊23735位患者(抑郁分量表总分≥26分且焦虑分量表总分≥20分)的抑郁和焦虑症状数据进行网络分析。结果网络显示症状“过分担忧”和“发抖”、“无故害怕”和“容易哭泣”之间存在明显的正则化偏相关。“感觉受骗,中了圈套或有人想抓您”、“感到苦闷”的预期影响最高;“发抖”、“一阵阵恐惧或惊恐”的桥预期影响最高。结论抑郁症状“感觉受骗,中了圈套或有人想抓您”、“感到苦闷”是网络中最重要的症状;焦虑症状“发抖”和“一阵阵恐惧或惊恐”是最关键的桥梁症状。以“发抖”和“一阵阵恐惧或惊恐”为主要的干预靶点,可能有助于预防和治疗精神科门诊患者抑郁和焦虑的共病。

Objective The study was designed to explore the depression and anxiety network in psychiatric outpatients.Methods A network analysis was performed on the data of depression and anxiety symptoms of 23735 patients in a general hospital outpatient department of mental and physical department(total score of depression subscale≥26 and total score of anxiety subscale≥20).Results The network shows that there is a clear regularization between the symptoms of"excessive worry"and"trembling","fear for no reason"and"easy to cry"."Feeling cheated,trapped or wanted","feeling depressed"had the highest expected impact;"trembling","waves of fear or panic"had the highest bridge expected impact.Conclusion Depressive symptom of"feeling duped,trapped or wanted"is the most important symptom in the network;anxiety symptoms of"shaking"and"waves of fear or panic"are the most critical bridging symptoms."Trembling"and"waves of fear or panic"as the main intervention targets may help to prevent and treat psychiatric outpatient with depression and anxiety comorbidity.