社区失能老人孤独抑郁焦虑的网络分析

Network Analysis of Loneliness-depression-anxiety Comorbidity Among Disabled Elderly in Community

目的基于网络视角探索社区失能老人孤独-抑郁-焦虑症状网络特征。方法采用便利抽样法选取西安市5个社区325例失能老人为研究对象,采用一般资料调查表、UCLA孤独感量表简化版(the short-form of the UCLA loneliness scale,ULS-8)、患者健康问卷抑郁症状量表(patients’health questionnaire depression scale-9 item,PHQ-9)、广泛性焦虑量表(generalized anxiety disorder-7 item scale,GAD-7)对其进行调查,运用R 4.1.1软件进行网络模型构建及分析。结果症状网络显示“做事时提不起劲或没有兴趣”和“感到心情低落、沮丧或绝望”存在最强的正则化偏相关(0.51);“感到心情低落、沮丧或绝望”(1.32)和“我感到孤独”(1.16)预期影响最高;“我感到孤独”(0.21)、“很难集中精神做事”(0.52)和“变得容易烦恼或易被激怒”(0.40)分别是孤独、抑郁和焦虑社团中桥预期影响最高的项目。结论“感到心情低落、沮丧或绝望”和“我感到孤独”为网络的核心症状,以此作为干预靶点可最大化降低网络的严重程度。“我感到孤独”“很难集中精神做事”和“变得容易烦恼或易被激怒”为关键的桥梁症状,可作为预防和治疗孤独、抑郁、焦虑共病的突破口。

Objective To explore the characteristics of loneliness-depression-anxiety symptom networks of disabled elderly based on a network perspective.Methods By the convenience sampling method,325 disabled elderly from 5 communities in Xi’an were selected,and a survey was conducted using the general information questionnaire,the short-form of the UCLA Loneliness Scale(ULS-8),Patients’Health Questionnaire Depression Scale-9 item(PHQ-9)and Generalized Anxiety Disorder-7 item scale(GAD-7).R4.1.1 software was adopted for network model construction and analysis.Results The symptom network showed that the strongest edge exist between“uninterested”and“depressed or sad mood”(0.51).“Depressed or sad mood”(1.32)and“feeling lonely”(1.16)had the highest EI values.“Feeling lonely”(0.21),“concentration difficulties”(0.52)and“irritable”(0.40)had the highest BEI values of their respective symptom clusters.Conclusions Targeted interventions for“depressed or sad mood”and“feeling lonely”may minimize the severity of the entire symptom network,which are identified as the core symptoms.“Feeling lonely”,“concentration difficulties”and“irritable”are critical bridging symptoms,which serve as a breakthrough point for preventing and treating disabled elderly with loneliness-depression-anxiety comorbidity.