抑郁症《国际功能、残疾和健康分类》功能变量关系图模型的建构研究  

Graph Modeling of Relational Structures among Functioning Variables with Depression:An Exploratory Analysis Based on International Classification of Functioning,Disability,and Health

作　　者：王雨 林枫 杨海龙[3] WANG Yu;LIN Feng;YANG Hai-long(Nanjing Drum Tower Hospital Clinical Colleage of Traditional Chinese and Western Medicine,Nanjing University of Chinese Medicine,Nanjing 210023,China;Department of rehabilitation medicine,The Affiliated Sir Run Run Hospital of Nanjing Medical University,Nanjing 211100,China;Department of Medical Psychology,Nanjing Drum Tower Hospital,The Affiliated Drum Tower Hospital,Medical School of Nanjing University,Nanjing 210008,China)

机构地区：[1]南京中医药大学中西医结合鼓楼临床医学院,南京210023 [2]南京医科大学附属逸夫医院康复医学科,南京211100 [3]南京大学医学院附属鼓楼医院医学心理科,南京210008

出　　处：《神经损伤与功能重建》2022年第12期718-721,771,共5页Neural Injury and Functional Reconstruction

摘　　要：目的:根据《国际功能、残疾和健康分类》(ICF)为抑郁症建立功能变量关系图模型,探索关键靶点条目和干预路径,为抑郁症的诊疗及心理社会功能恢复提供新的思路和依据。方法:175例抑郁症患者纳入研究,使用自编一般情况调查问卷、病人健康问卷(PHQ-9)、广泛性焦虑量表(GAD-7)、24项汉密尔顿抑郁量表(HAMD-24)和抑郁症ICF综合核心条目组合对患者进行评估,采用R软件构建功能变量关系图模型,并进行网络分析。结果:①共有62个ICF条目位于抑郁症功能变量主岛屿结构中;其中27个条目位于4-核结构,30个条目位于3-核结构,5个条目位于2-核结构;各条目的障碍率与网络参数未发现显著相关(P>0.05)。②频数分布结果显示,4-核结构中的27个条目障碍率取值范围基本与各条目功能障碍频数分布一致,4-核中所有条目可作为关键干预靶点。③风险相关结果显示,乐观、思维功能、动机、与消化系统相关感觉、痛觉等与多个条目之间具有较高风险相关,可为设计不同的干预路径提供参考。结论:通过构建抑郁症ICF功能变量关系图模型,可发掘抑郁症关键干预靶点和临床路径,进一步指导抑郁症的诊疗及促进患者心理社会功能恢复。Objective:To establish a graphic model of functional variables for depression according to the International Classification of Functioning,Disability,and Health(ICF)to explore the key target items and intervention paths,so as to provide new ideas and a basis for diagnosis and treatment of depression and recovery of psychosocial function.Methods:A total of 175 patients with depression were selected as research subjects.Patients were assessed by self-designed general condition questionnaire,patient health questionnaire(PHQ-9),Generalized Anxiety Disorder Scale(GAD-7),24-item Hamilton Depression Scale(HAMD-24),and ICF Core Sets for depression.R software was used for modeling variable relationships and network analysis.Results:(1)A total of 62 ICF items were located in the main structure of depression,among which 27 items were located in the 4-coreness structure,30 in the 3-coreness structure,and 5 in the 2-coreness structure.There was no significant correlation between the disability rate of each item and network parameters(P>0.05).(2)The results of frequency distributions showed that the range of the disorder rate of 27 items in the 4-coreness structure was basically consistent with the frequency distribution of the dysfunction rate of each item,and all items in the 4-coreness structure could be used as key intervention targets.(3)The results of risk correlation showed that items like optimism,thought functions,motivation,sensations associated with the digestive system,and sensation of pain had high risk correlation with multiple items,which can be used to guide the design of different intervention paths.Conclusion:The key target items and intervention paths can be explored by constructing the graphical model of ICF functional variables for depression,which will further guide the diagnosis,treatment,and recovery of psychosocial function in depression.

关 键 词：抑郁症 国际功能、残疾和健康分类 图建模 网络分析 

分 类 号：R741[医药卫生—神经病学与精神病学] R741.02[医药卫生—临床医学] R749