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

作　　者：王慧 马辉[2] 刁凯丽 曲海涛[4] 滕昌军 尹程 杨华[2] 张宁[2] Wang Hui;Ma Hui;Diao Kaili;Qu Haitao;Teng Changjun;Yin Cheng;Yang Hua;Zhang Ning(The Forth Clinical College of Nanfing Medical University,Nanjing 210029,China;Department of Psychology,the Affiliated Brain Hospital of Nanjing Medical University,Nanjing 210029,China;School of Psychology,Nanjing Normal University,Nanfing 210024,China;Mental Health Education and Counseling Center,Nanjing University of Posts and Telecommmunications ,Nanjink 210023.China)

机构地区：[1]南京医科大学第四临床医学院,南京210029 [2]南京医科大学附属脑科医院医学心理科,南京210029 [3]南京师范大学心理学院,南京210097 [4]南京邮电大学心理健康与咨询中心,南京210023

出　　处：《中华行为医学与脑科学杂志》2018年第12期1091-1095,共5页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：江苏省重点研发计划(社会发展)项目(BE2015609);南京市医学科技发展重点项目(ZKX10022);国家临床重点专科建设项目(精神科,卫生部医政司2011-873);江苏省医学重点学科(精神病学,江苏省卫生厅2011-12).

摘　　要：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.

关 键 词：抑郁症 临床治愈 心理社会功能 症状自评 负性自动思维 

分 类 号：R749.4[医药卫生—神经病学与精神病学]