伴非典型特征抑郁与运动水平、昼夜节律及抑郁严重程度的关系

Relationship among atypical depression,physical activity,circadian rhythm and depression severity

目的探讨伴非典型特征抑郁(AD)、运动水平、昼夜节律和抑郁严重程度的关系并分析运动水平和昼夜节律的中介作用。方法采用抑郁症状问卷(IDS-SR30)、体育活动等级量表(PARS-3)、清晨型与夜晚型量表(MEQ)、患者健康问卷(PHQ-9)对172例门诊抑郁患者开展调查。结果AD患者PARS-3、MEQ得分均低于non-AD患者(P<0.05),AD患者PHQ-9得分高于non-AD患者(P<0.05)。相关性分析结果显示,PARS-3得分与MEQ得分呈正相关(P<0.05),PHQ-9得分与PARS-3得分及MEQ得分均呈负相关(P<0.05)。中介效应分析显示,控制性别变量后,运动水平和昼夜节律是伴非典型特征抑郁与抑郁严重程度间的中介变量,效应量分别为21.18%、17.06%,运动水平和昼夜节律在伴非典型特征抑郁与抑郁严重程度间起到链式中介作用,效应量为2.94%。结论伴非典型特征抑郁的预防及治疗可以从提高运动水平和改善昼夜节律入手。

Objective To explore the relationship among atypical depression(AD),physical activity,circadian rhythm and depression severity,and to analyze the mediating effect of physical activity and circadian rhythm.Methods A total of 172 outpatients with depression were assessed with Inventory of Depressive Symptomatology Self-Report(IDS-SR30),Physical Activity Rating Scale-3(PARS-3),Morningness/Eveningness Questionnaire(MEQ),Patient Health Questionnaire-9(PHQ-9).Results Compared with non-AD patients,patients with AD had lower PARS-3 and MEQ scores and higher PHQ-9 score(P<0.05).Correlation analysis showed that PARS-3 score was positively correlated with MEQ score(P<0.05),and PHQ-9 score was negatively correlated with PARS-3 and MEQ scores(P<0.05).The mediation effect analysis showed that after controlling gender variable,physical activity and circadian rhythm were the mediating variables between AD and depression severity(effect sizes=21.18%,17.06%).Physical activity and circadian rhythm played a chain mediating role between AD and depression severity(effect size=2.94%).Conclusion Prevention and treatment of AD can be started from increasing physical activity and improving circadian rhythm.