目的:研究基本的人口学变量对抑郁症患者认知功能的影响,进一步了解抑郁症患者在认知功能受损下的人格特征的特点以及日常处理问题的应对方式,并分析三者间的相关性。方法:采用抑郁自评量表(SDS)的评分作为纳入标准,总分超过60即中度抑郁以上,以及功能失调性状况量表总分高于130作为标准,符合两个标准方才纳入。应用艾森克人格问卷简式量表(EPQ-RSC)和简易应对方式问卷(SCSQ)来研究抑郁症病患认知功能受损下的人格特征和应对方式。总共接受问卷调查113人,最后纳入75人。应用SPSS软件进行分析,对人口学变量采用独立样本t检验,有多组水平的进行单因素方差分析。在对人格特征、应对方式与抑郁症认知功能进行相关性研究中,采用Pearson相关性分析。采用多元回归分析来预测人格特征和应对方式对于抑郁症认知功能损害的影响。结果:认知功能的影响因素有年龄、性别、生源地、是否独生、受教育程度(P > 0.05)均无显著统计学差异。人格特征中神经质维度与抑郁症认知功能损害正相关(γ = 0.438; P < 0.05),内外倾性维度与抑郁症认知功能损害负相关(γ = −0.335; P < 0.05);应对方式积极方式与抑郁症认知功能损害负相关(γ= −0.415; P < 0.05),消极应对方式与抑郁症认知功能损害正相关(γ = 0.299; P < 0.05)。结论:人口学变量对抑郁症患者的认知功能影响不大,人格特征和应对方式与抑郁症认知功能有着密切关系,神经质、消极方式和积极方式会对抑郁症认知功能产生显著影响并有预测作用。 Objective: To study the impact of basic demographic variables on the cognitive function of patients with depression, to further understand the personality characteristics of patients with depression with impaired cognitive function and the coping style of daily dealing with problems, and to analyze the correlation among them. Methods: The score of self-rating Depression Scale (SDS) was used as the inclusion criteria, with a total score of more than 60 indicating moderate depression and a total score of more than 130 as the criteria. Inclusion criteria were only met when the two criteria were met. Eysenck Personality Questionnaire (EPQ-RSC) and Simple Coping Style Questionnaire (SCSQ) were used to study the personality characteristics and coping styles of depressed patients with im-paired cognitive function. A total of 113 people were surveyed, and 75 were finally included. SPSS software was used for analysis, independent sample T test was used for demographic variables, and one-way ANOVA was performed for multiple groups of levels. Pearson correlation analysis was used in the correlation study of personality characteristics, coping style and cognitive function of depres-sion. Multiple regression analysis was used to predict the effects of personality traits and coping styles on cognitive impairment of depression. Results: Factors influencing cognitive function include age, gender, place of origin, one-child or not, and education level (P > 0.05); there was no significant statistical difference. Neuroticism was positively correlated with cognitive impairment in depres-sion (γ = 0.438; P < 0.05); the extraverted dimension was negatively correlated with cognitive im-pairment of depression (γ = −0.335; P < 0.05); positive coping styles were negatively correlated with cognitive impairment in depression (γ = −0.415; P < 0.05), negative coping style was positively correlated with cognitive impairment of depression (γ = 0.299; P < 0.05). Conclusion: Demographic variables have little influence on the cognitive function of patients with depression. Personality characteristics and coping styles are closely related to the cognitive function of depression. Neuroti-cism, negative and positive ways have significant influence and predictive effect on the cognitive function of depression.
目的:研究基本的人口学变量对抑郁症患者认知功能的影响,进一步了解抑郁症患者在认知功能受损下的人格特征的特点以及日常处理问题的应对方式,并分析三者间的相关性。方法:采用抑郁自评量表(SDS)的评分作为纳入标准,总分超过60即中度抑郁以上,以及功能失调性状况量表总分高于130作为标准,符合两个标准方才纳入。应用艾森克人格问卷简式量表(EPQ-RSC)和简易应对方式问卷(SCSQ)来研究抑郁症病患认知功能受损下的人格特征和应对方式。总共接受问卷调查113人,最后纳入75人。应用SPSS软件进行分析,对人口学变量采用独立样本t检验,有多组水平的进行单因素方差分析。在对人格特征、应对方式与抑郁症认知功能进行相关性研究中,采用Pearson相关性分析。采用多元回归分析来预测人格特征和应对方式对于抑郁症认知功能损害的影响。结果:认知功能的影响因素有年龄、性别、生源地、是否独生、受教育程度(P > 0.05)均无显著统计学差异。人格特征中神经质维度与抑郁症认知功能损害正相关(γ = 0.438; P < 0.05),内外倾性维度与抑郁症认知功能损害负相关(γ = −0.335; P < 0.05);应对方式积极方式与抑郁症认知功能损害负相关(γ= −0.415; P < 0.05),消极应对方式与抑郁症认知功能损害正相关(γ = 0.299; P < 0.05)。结论:人口学变量对抑郁症患者的认知功能影响不大,人格特征和应对方式与抑郁症认知功能有着密切关系,神经质、消极方式和积极方式会对抑郁症认知功能产生显著影响并有预测作用。
抑郁症,认知功能,影响因素,人格特征,应对方式
Conghui Wang1, Xiong Chen1, Juan Wang2, Chunqi Ai1*
1Department of Mental Health Center, Shiyan Taihe Hospital (Affiliated Hospital of Hubei University of Medicine), Shiyan Hubei
2College of Humanities, Hubei University of Medicine, Shiyan Hubei
Received: Apr. 19th, 2021; accepted: May 19th, 2021; published: May 27th, 2021
Objective: To study the impact of basic demographic variables on the cognitive function of patients with depression, to further understand the personality characteristics of patients with depression with impaired cognitive function and the coping style of daily dealing with problems, and to analyze the correlation among them. Methods: The score of self-rating Depression Scale (SDS) was used as the inclusion criteria, with a total score of more than 60 indicating moderate depression and a total score of more than 130 as the criteria. Inclusion criteria were only met when the two criteria were met. Eysenck Personality Questionnaire (EPQ-RSC) and Simple Coping Style Questionnaire (SCSQ) were used to study the personality characteristics and coping styles of depressed patients with impaired cognitive function. A total of 113 people were surveyed, and 75 were finally included. SPSS software was used for analysis, independent sample T test was used for demographic variables, and one-way ANOVA was performed for multiple groups of levels. Pearson correlation analysis was used in the correlation study of personality characteristics, coping style and cognitive function of depression. Multiple regression analysis was used to predict the effects of personality traits and coping styles on cognitive impairment of depression. Results: Factors influencing cognitive function include age, gender, place of origin, one-child or not, and education level (P > 0.05); there was no significant statistical difference. Neuroticism was positively correlated with cognitive impairment in depression (γ = 0.438; P < 0.05); the extraverted dimension was negatively correlated with cognitive impairment of depression (γ = −0.335; P < 0.05); positive coping styles were negatively correlated with cognitive impairment in depression (γ = −0.415; P < 0.05), negative coping style was positively correlated with cognitive impairment of depression (γ = 0.299; P < 0.05). Conclusion: Demographic variables have little influence on the cognitive function of patients with depression. Personality characteristics and coping styles are closely related to the cognitive function of depression. Neuroticism, negative and positive ways have significant influence and predictive effect on the cognitive function of depression.
Keywords:Depression, Cognitive Function, Influencing Factors, Personality Traits, Coping Styles
Copyright © 2021 by author(s) and Hans Publishers Inc.
This work is licensed under the Creative Commons Attribution International License (CC BY 4.0).
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据统计,目前全球已确诊抑郁症的人数在3亿左右,得病比率上涨了18%,预测至2020年抑郁症将会成为致死和致残的重大因素 [
抑郁易感性得到了学者们的重视,作为疾病产生的内在根源,在一定条件具备的情况下会引发抑郁症状,而抑郁的易感性与认知有着密不可分的关系。既往研究 [
对2020年4月至2020年12月在我院门诊首诊或既往有确诊本次复发的患者进行为期一周网络观察,通过网络发布问卷,最终纳入75名抑郁症患者。纳入标准:主动来我院就诊,且抑郁自评量表的评分大于60分;功能失调性态度问卷评分大于130分。排除标准:1) 共病其他精神疾病,如重性精神疾病及物质滥用史者;2) 诊断明确的神经系统疾病及严重或不稳定的躯体疾病。
所有受试者本人及家属均明白本研究的目的,自愿参加本研究并签署知情同意书。本研究通过十堰市太和医院伦理委员会的审核批准。
人口学资料:包括年龄、性别、出生地来源、是否独生,受教育水平这五个因素。
抑郁症状评定:采用抑郁自评量表(SDS),该量表的信效度在研究中心得到了较好的检验 [
人格特征评定:艾森克人格问卷简式量表中国版(EPQ-RSC),该测评工具分为四个结构,分别是精神质(P):正向计分10, 14, 22, 31, 39,反向计2, 6, 18, 26, 28, 35, 43;外倾性(E):正向计分3, 7, 11, 15, 19, 23, 32, 36, 41, 44, 48反向计分27;神经质(N):正向计分1, 5, 9, 13, 17, 21, 25, 30, 34, 38, 42, 46,反向计分:无;掩饰量表(L):正向计分4, 16, 45,反向计分8, 12, 20, 24, 29, 33, 37, 40, 47,该量表具有较好的信效度 [
应对方式评定:简易应对方式问卷(SCSQ)由20个题目组成,涉及人们在日常生活中经常可能采取的措施。该测量工具分为两个维度,取前12题的平均分来评估积极因子。消极维度与之相同,题目是后面剩下的部分。评估方法主要是通过计分,统计用0~3的四级评分法,总分越高,那么相对的因子倾向越明显,该量表的信效度得到了较好的验证 [
采用SPSS19.0统计软件进行数据分析,计量数据用独立样本t检验或单因素方差分析,用平均值±标准差 ( x ¯ ± s ) 描述,相关性分析用Pearson相关系数分析,预测变量影响用多元回归分析。
本次实际接收问卷的有114名人员,其中有效问卷75份。在有效问卷中,11~16岁的青春期人员有7名,17~25岁的青少年有57名,26~34岁的青年期有11名,经单因素方差分析,组间无显著差异(F = 1.921, P > 0.05)。在有效问卷中,男生有30名,女生45名,经独立样本t检验,无显著差异(t = 0.669, P > 0.05)。在城市长大的有36名,在乡村成长的有39名,经独立样本t检验,差异不显著(t = 0.211, P > 0.05)。在有效问卷中,独生子女有34名,非独生子女有41名,经独立样本t检验,不具有显著差异(t = 0.840, P > 0.05)。分析受教育水平,小学有1名,中学及以上有18名,专科及以上有56名,经单因素方差分析,没有显著差异(F = 0.299, P > 0.05)。
年龄、性别、生源地、是否独生以及受教育程度对抑郁症认知功能均无显著影响,具体可见表1。
因素 | n | DAS | F或t/P | |
---|---|---|---|---|
年龄 | 11~16 | 7 | 189.86 ± 37.078 | 1.921/0.154 |
17~25 | 57 | 194.88 ± 29.054 | ||
26~34 | 11 | 213.09 ± 30.596 | ||
性别 | 男 | 30 | 199.97 ± 31.767 | 0.669/0.506 |
女 | 45 | 195.16 ± 29.643 | ||
出生地 | 城市 | 36 | 196.31 ± 33.755 | 0.211/0.834 |
农村 | 39 | 197.79 ± 27.349 | ||
独生子女 | 是 | 34 | 200.32 ± 30.156 | 0.840/0.404 |
否 | 41 | 194.39 ± 30.692 | ||
文化程度 | 小学 | 1 | 187 | 0.299/0.743 |
中学及中专 | 18 | 201.61 ± 34.721 | ||
大专及以上 | 56 | 195.80 ± 29.322 |
表1. 抑郁症患者认知功能的影响因素
抑郁症患者认知功能评分DAS与人格特征中神经质评分成正相关(γ = 0.438, P < 0.05),与外倾性评分成负相关(γ = −0.335, P < 0.05);抑郁症患者认知功能评分DAS与应对方式中积极应对成负相关(γ = −0.415, P < 0.05),与消极应对成正相关(γ = 0.299, P < 0.05),具体可见表2。
项目 | x ¯ ± s | DAS | |
---|---|---|---|
γ | p | ||
N | 10.84 ± 1.896 | 0.438 | 0.000 |
P | 4.41 ± 2.034 | −0.010 | 0.935 |
L | 3.61 ± 2.750 | −0.141 | 0.227 |
E | 3.13 ± 3.260 | −0.335 | 0.003 |
积极应对 | 14.05 ± 5.788 | −0.415 | 0.000 |
消极应对 | 12.93 ± 4.855 | 0.299 | 0.009 |
表2. 抑郁症认知功能与EPQ-RSC、SCSQ评分的相关
在人格特征、应对方式对抑郁症患者认知功能进行的多元回归分析中,因变量为抑郁症患者认知功能,预测变量是精神质、外倾性、神经质、掩饰性、积极应对和消极应对。方程模型P < 0.05,说明该回归方程有使用价值。R2为0.487,说明预测变量可以解释因变量48.7%的变化。其中应对方式中积极方式t = −4.648, P < 0.05,说明对认知功能有着显著的负向影响,消极方式t = 4.717, P < 0.05,说明对认知功能有着显著的正向影响,人格特征中的神经质t = 2.507, P < 0.05,对认知功能有着显著的正向影响。详见表3。
因变量预测变量 | R | R2 | F | P | b | SE | β | t | p |
---|---|---|---|---|---|---|---|---|---|
抑郁方程模型 | 0.698 | 0.487 | 10.73 | 0.00 | … | … | … | … | … |
症患精神质 | … | … | … | … | −1.8 | 1.45 | −0.12 | −1.278 | 0.206 |
者认外倾性 | … | … | … | … | −1.4 | 0.86 | −0.15 | −1.679 | 0.098 |
知功神经质 | … | … | … | … | 4.03 | 1.61 | 0.252 | 2.507 | 0.015 |
能掩饰性 | … | … | … | … | 0.50 | 1.05 | 0.046 | 0.481 | 0.632 |
消极应对 | … | … | … | … | −2.4 | 0.53 | −0.47 | −4.648 | 0.000 |
积极应对 | … | … | … | … | 2.77 | 0.58 | 0.443 | 4.717 | 0.000 |
表3. 人格特征、应对方式对抑郁症患者认知功能的多元回归分析
本研究显示年龄对抑郁症认知功能无显著影响。根据以往研究 [
之前往相关研究 [
应对方式中的二因子都与抑郁症患者的认知功能具有相关关系,病患在完成日常任务时会采取消极的处理方式,责怪自己、无法面对事实、把事情合理化等方式,采取积极方式的抑郁症患者认知功能损害的可能性更低,而消极方式会使症状更加糟糕。当病患习惯了采用消极的处理方式,那么会更多的默认这种习惯化了的处理结构,弱化积极方式在日常中应用,形成恶性循环。所以要重视对抑郁症患者在日常中处理问题的方式,鼓励其在面对应激状态时采用积极的应对方式,同时加大社会支持来源,帮助其解决不良情绪。
在本研究中,通过多元回归分析,个体神经质越不稳定,那么在患病中认知功能受到损害的影响越大。这与国外研究,病理性人格特征对于抑郁症具有显著的预测作用结论是一致的 [
侧重于某一项因素对与抑郁症认知功能的作用影响是当下的研究趋势,但由于抑郁症认知功能的复杂性很多因素都是同时影响的,本研究对于人特特征和应对方式与抑郁症患者认知功能的关系的理清,对于抑郁症日后的预防、治疗和预后都指明了一个方向。同时认识到应对方式的影响作用,用正确的方式让病患感到背后有支持,慢慢恢复正常的社会交往,提高生活幸福感和满足感,降低患病率。在早期对于抑郁症患者的人格特征进行干预,采取有效手段缓解认知损害,提高康复率,同时也告知在临床治疗中要重视人格特征的影响。由于网络研究的局限性,样本数量不够大,同时如果想做进一步追踪研究,在网络世界的可能性也不大。由于问卷大多是自评问卷,且在网络进行,没有指导者,可能会影响到测评分数的可靠性。在选取问卷的时候,受到问卷题量的限制,大多选的简式问卷,忽略了许多因子,没有得到进一步充分的分析。以及没有进一步的提出合适的治疗方案,应用到日常治疗中。
人格特征中和应对方式与抑郁症患者认知功能具有相关关系,而且人格特征和应对方式中的一些因子对抑郁症患者认知功能具有显著的影响,本研究结果给抑郁症认知功能的预防和治疗都提供了新的思路,临床治疗中关注人格特征和应对方式,努力提高病患生活幸福感,降低抑郁症患者的发病率和提高预后。
2020年度太和医院软科学项目(编号:2020rkt07)。
王聪慧,陈 雄,王 娟,艾春启. 抑郁症患者认知功能的影响因素及其与人格特征、应对方式之间的相关性研究A Study on the Influence Factors of Cognitive Function and Their Correlation with Personality Characteristics and Coping Styles in Patients with Depression[J]. 国际神经精神科学杂志, 2021, 10(02): 80-87. https://doi.org/10.12677/IJPN.2021.102102011