depression

抑郁症
  • 文章类型: Journal Article
    背景:尽管它很受欢迎,缺乏关于心理急救(PFA)有效性的证据。目的:评估PFA,与心理教育相比,注意安慰剂对照,干预后3个月可减少PTSD和抑郁症状。方法:在两个急诊科,166名近期创伤的成年幸存者被随机分配到一次PFA(n=78)(主动倾听,呼吸再训练,需求分类,协助转介社交网络,和PsyEd)或独立的PsyEd(n=88)。在基线(T0)评估PTSD和抑郁症状,一(T1),以及干预后三个月(T2),使用PTSD清单(T0时的PCL-C和T1/T2时的PCL-S)和贝克抑郁量表-II(BDI-II)。自我报告的副作用,创伤后酒精/物质消耗和人际冲突增加,和使用精神药物,心理治疗,病假,和补充/替代医学也进行了探索。结果:86名参与者(随机分组的51.81%)在T2时退出。PsyEd组的很大一部分参与者也接受了PFA成分(即污染)。从T0到T2,我们没有发现PFA在减少PTSD(p=.148)或抑郁症状(p=.201)方面的显着优势。然而,我们发现了一个显著的剂量反应效应之间的输送成分的数量,会话持续时间,和减轻创伤后应激障碍症状。自我报告的不良反应没有显着差异。在T2时,分配给PFA的参与者的较小比例报告酒精/物质的消费量增加(OR=0.09,p=.003),人际冲突(OR=0.27,p=0.014),并使用过精神药物(OR=0.23,p=0.013)或病假(OR=0.11,p=0.047)。结论:干预后三个月,我们没有发现证据表明PFA在减轻PTSD或抑郁症状方面优于PsyEd.污染可能影响了我们的结果。PFA,尽管如此,似乎有希望改变一些创伤后的行为。需要进一步的研究。
    创伤后早期广泛推荐心理急救(PFA)。我们评估了PFA减轻创伤后3个月PTSD症状和其他问题的有效性。我们没有找到PFA有效性的确切证据。尽管如此,这似乎是一个安全的干预。
    Background: Despite its popularity, evidence of the effectiveness of Psychological First Aid (PFA) is scarce.Objective: To assess whether PFA, compared to psychoeducation (PsyEd), an attention placebo control, reduces PTSD and depressive symptoms three months post-intervention.Methods: In two emergency departments, 166 recent-trauma adult survivors were randomised to a single session of PFA (n = 78) (active listening, breathing retraining, categorisation of needs, assisted referral to social networks, and PsyEd) or stand-alone PsyEd (n = 88). PTSD and depressive symptoms were assessed at baseline (T0), one (T1), and three months post-intervention (T2) with the PTSD Checklist (PCL-C at T0 and PCL-S at T1/T2) and the Beck Depression Inventory-II (BDI-II). Self-reported side effects, post-trauma increased alcohol/substance consumption and interpersonal conflicts, and use of psychotropics, psychotherapy, sick leave, and complementary/alternative medicine were also explored.Results: 86 participants (51.81% of those randomised) dropped out at T2. A significant proportion of participants in the PsyEd group also received PFA components (i.e. contamination). From T0 to T2, we did not find a significant advantage of PFA in reducing PTSD (p = .148) or depressive symptoms (p = .201). However, we found a significant dose-response effect between the number of delivered components, session duration, and PTSD symptom reduction. No significant difference in self-reported adverse effects was found. At T2, a smaller proportion of participants assigned to PFA reported increased consumption of alcohol/substances (OR = 0.09, p = .003), interpersonal conflicts (OR = 0.27, p = .014), and having used psychotropics (OR = 0.23, p = .013) or sick leave (OR = 0.11, p = .047).Conclusions: Three months post-intervention, we did not find evidence that PFA outperforms PsyEd in reducing PTSD or depressive symptoms. Contamination may have affected our results. PFA, nonetheless, appears to be promising in modifying some post-trauma behaviours. Further research is needed.
    Psychological First Aid (PFA) is widely recommended early after trauma.We assessed PFA\'s effectiveness for decreasing PTSD symptoms and other problems 3 months post-trauma.We didn\'t find definitive evidence of PFA’s effectiveness. Still, it seems to be a safe intervention.
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  • 文章类型: Journal Article
    认知刺激疗法(CST)是一种基于证据的疗法,对轻度至中度痴呆的老年人的非药物干预。虽然CST已经以各种方式进行了调整,这项研究探讨了在CST中增加精神维度的影响。参与者(N=34)根据其居住地分为精神和传统CST组。经过涉及互动对话的14次干预,精神CST组的抑郁评分(M=2.7)明显低于传统CST(M=6.5).随着全球痴呆症相关疾病的增加,CST等非药物干预措施为解决记忆丧失提供了至关重要的支持.社会工作者处于独特的位置,可以向重视日常生活中的灵性或信仰的不同人群提供CST。
    Cognitive Stimulation Therapy (CST) is an evidence-based, non-pharmacological intervention for older adults with mild to moderate dementia. While CST has been adapted in various ways, this study explored the impact of adding a spiritual dimension to CST. Participants (N = 34) were divided into spiritual and traditional CST groups based on their residence. After a 14-session intervention involving interactive conversations, the spiritual CST group showed significantly lower depression scores (M = 2.7) compared to traditional CST (M = 6.5). With the global increase in dementia-related disorders, non-pharmacological interventions like CST offer crucial support for addressing memory loss. Social workers are uniquely positioned to deliver CST to diverse populations who value spirituality or faith in their daily lives.
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  • 文章类型: Journal Article
    比较2022年上海Omicronwave之前和期间孕妇的焦虑和抑郁严重程度及其对后续出生结局的影响。
    比较了暴发期间的孕妇(暴发组;n=783)和暴发前的孕妇对照组(暴发前组;n=783)之间的抑郁-焦虑症状网络。基线精神状态对随访妊娠和新生儿结局的影响也通过logistic回归分析。
    两组之间的抑郁和焦虑水平差异无统计学意义。网络分析显示,两组都有中心症状“放松困难”和桥梁症状“抑郁情绪”。大流行不同时期的不同症状关联。产前抑郁和焦虑严重程度的总分和亚症状评分增加了孕产妇和新生儿综合征的优势比。精神状态对妊娠和新生儿结局的影响在不同的大流行时期有所不同。
    Omicron波对孕妇的抑郁和焦虑情绪没有明显的负面影响。针对中枢和桥梁症状干预可能有效减少其对焦虑和抑郁情绪和分娩结局的共同发生的不利影响。
    UNASSIGNED: Comparing the anxiety and depression severity and their impact on subsequent birth outcomes in pregnant women before and during Omicron wave in Shanghai in 2022.
    UNASSIGNED: The depression-anxiety symptoms networks were compared between the pregnant women during the outbreak period (outbreak group; n = 783) and a matched control group of pregnant women before the outbreak (pre-outbreak group; n = 783). The impact of baseline mental state on follow-up pregnancy and neonatal outcomes was also explored by logistic regression.
    UNASSIGNED: Levels of depression and anxiety between the two groups were not significant different. Network analysis showed that central symptom \"trouble relaxing\" and bridge symptom \"depressed mood\" shared by both groups. Different symptom associations in different periods of the pandemic. Total scores and sub-symptom scores of prenatal depressive and anxious severities increased the odds ratios of maternal and neonatal syndromes. The influence of mental state on gestational and neonatal outcomes differed across different pandemic periods.
    UNASSIGNED: The Omicron wave did not have a significant negative impact on the depressive and anxious mood in pregnant women. Targeting central and bridge symptoms intervention may be effective in reducing their adverse effects on co-occurring of anxious and depressive mood and birth outcomes.
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  • 文章类型: Journal Article
    背景:糖尿病自主神经病变(DAN)是糖尿病(DM)的一种普遍但经常被忽视的并发症,影响多个器官,并大幅提高发病率和死亡率的风险。这项研究旨在评估基于瑜伽的干预(YBI)与美国糖尿病协会运动方案(ADAEx。方案)和治疗2型糖尿病自主神经病变的标准护理。
    方法:这项开放标签的探索性临床试验有两个平行的研究组:A组(干预),与标准护理一起接受了YBI,B组,遵守ADAEx。制度与标准护理相结合。共有80名35-60岁的参与者,诊断为2型糖尿病和自主神经病变,被平均分配给两组。数据收集包括神经传导速度(NCV)测试,自主功能测试(AFTs),以及对抑郁和生活质量的评估。
    结果:与ADAEx相比,YBI显示副交感神经张力下降。政权.经过六个月的干预,YBI组的交感神经活动指标(SD2)显示出比ADAEx明显更低的值。政权组,表明有积极的影响(p<0.05),而ADAEx.制度在NCV的某些领域显示出更多的改进(例如,左右腓骨NCV,右和左腓骨F延迟),碱性磷酸酶水平存在显著差异,抑郁评分,和WHO-5健康,均在p<0.05时达到统计学意义。
    结论:研究发现,24周YBI可显著降低糖尿病性神经病变和应激的症状。虽然ADA前。与YBI相比,制度在NCV的特定方面表现出更大的改进,YBI的表现优于ADAEx。加强WHO-5健康和减少抑郁症状的制度。
    BACKGROUND: Diabetic autonomic neuropathy (DAN) is a prevalent yet often overlooked complication of diabetes mellitus (DM), impacting multiple organs and substantially elevating the risk of morbidity and mortality. This study aimed to assess the effectiveness of yoga-based intervention (YBI) compared to the American Diabetes Association exercise regimen (ADA Ex. Regime) and standard care for treating autonomic neuropathy in type 2 DM.
    METHODS: This open-label exploratory clinical trial featured two parallel study arms: Group A (Intervention), which received YBI alongside standard care, and Group B, which adhered to the ADA Ex. Regime in conjunction with standard care. A total of 80 participants aged 35-60, diagnosed with type 2 DM and autonomic neuropathy, were equally allocated to both groups. Data collection included nerve conduction velocity (NCV) tests, autonomic function tests (AFTs), as well as evaluations of depression and quality of life.
    RESULTS: YBI demonstrated a drop in parasympathetic tone compared to the ADA Ex. Regime. Following a six-month intervention, the sympathetic activity indicator (SD2) exhibited a significantly lower value in the YBI group than in the ADA Ex. Regime group, indicating a positive effect (p < 0.05), while the ADA Ex. Regime showed more improvement in certain areas of NCV (e.g., left and right peroneal NCV, right and left peroneal F-latency), notable differences were observed in alkaline phosphatase levels, depression scores, and WHO-5 wellness, all reaching statistical significance at p < 0.05.
    CONCLUSIONS: The study findings observed that a 24-week YBI significantly reduced in symptoms of diabetic neuropathy and stress. Although the ADA Ex. Regime demonstrated greater improvement in specific aspects of NCV compared to YBI, YBI outperformed the ADA Ex. Regime in enhancing WHO-5 wellness and reducing depression symptoms.
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  • 文章类型: Journal Article
    心率变异性生物反馈(HRVB)是一种经过充分研究的干预措施,以其对情绪的积极影响而闻名。认知,和生理健康,包括缓解抑郁症状.然而,它的实际使用受到高成本和缺乏训练有素的专业人员的阻碍。基于智能手机的HRVB,这消除了对外部设备的需求,提供了一个有希望的替代方案,尽管研究有限。此外,经前症状在经期个体中非常普遍,需要低成本,可获得的干预措施,副作用最小。通过这项试点研究,我们的目标是测试,第一次,基于智能手机的HRVB对抑郁和经前症状的影响,以及焦虑/压力症状和注意力控制。
    27名具有高于平均水平的经前或抑郁症状的参与者使用等待列表控制设计进行了为期4周的基于智能手机的光电体积描记术HRVB干预。在干预前后进行了实验室会议,相隔4周。评估包括静息性迷走神经介导的心率变异性(vmHRV),通过修订的注意力网络测试(ANT-R)进行注意力控制,用BDI-II问卷评估抑郁症状,和使用DASS问卷测量的压力/焦虑症状。如果适用,通过PAF问卷记录经前症状。数据分析采用线性混合模型。
    我们观察到经前的改善,抑郁,和焦虑/压力症状,以及ANT-R在干预期间的执行功能评分,而不是在等待列表阶段。然而,我们没有发现vmHRV或ANT-R的定向评分有明显变化。
    这些发现很有希望,无论是基于智能手机的HRVB的有效性还是其缓解经前症状的潜力。然而,提供关于使用HRVB改善经前症状的可靠建议,需要更大样本量的进一步研究来复制这些效应.
    UNASSIGNED: Heart rate variability biofeedback (HRVB) is a well-studied intervention known for its positive effects on emotional, cognitive, and physiological well-being, including relief from depressive symptoms. However, its practical use is hampered by high costs and a lack of trained professionals. Smartphone-based HRVB, which eliminates the need for external devices, offers a promising alternative, albeit with limited research. Additionally, premenstrual symptoms are highly prevalent among menstruating individuals, and there is a need for low-cost, accessible interventions with minimal side effects. With this pilot study, we aim to test, for the first time, the influence of smartphone-based HRVB on depressive and premenstrual symptoms, as well as anxiety/stress symptoms and attentional control.
    UNASSIGNED: Twenty-seven participants with above-average premenstrual or depressive symptoms underwent a 4-week photoplethysmography smartphone-based HRVB intervention using a waitlist-control design. Laboratory sessions were conducted before and after the intervention, spaced exactly 4 weeks apart. Assessments included resting vagally mediated heart rate variability (vmHRV), attentional control via the revised attention network test (ANT-R), depressive symptoms assessed with the BDI-II questionnaire, and stress/anxiety symptoms measured using the DASS questionnaire. Premenstrual symptomatology was recorded through the PAF questionnaire if applicable. Data analysis employed linear mixed models.
    UNASSIGNED: We observed improvements in premenstrual, depressive, and anxiety/stress symptoms, as well as the Executive Functioning Score of the ANT-R during the intervention period but not during the waitlist phase. However, we did not find significant changes in vmHRV or the Orienting Score of the ANT-R.
    UNASSIGNED: These findings are promising, both in terms of the effectiveness of smartphone-based HRVB and its potential to alleviate premenstrual symptoms. Nevertheless, to provide a solid recommendation regarding the use of HRVB for improving premenstrual symptoms, further research with a larger sample size is needed to replicate these effects.
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  • 文章类型: Journal Article
    社会经济地位(SES)对抑郁症状的影响已得到广泛研究;然而,以前的研究通常使用以变量为中心的方法和横截面设计。因此,本研究探讨了抑郁症的亚型,并研究了SES与潜在转变概率之间的关联程度.我们对2015年和2018年中国健康与退休纵向研究(N=4904)的数据进行了潜在概况和潜在转变分析。根据症状确定了三种抑郁症亚型:严重症状(SS),低症状(LS),和亚健康(MS)。SS亚型具有最高的保持在原始亚型内的概率。MS亚型中的个体比LS亚型中的个体更可能移至SS亚型。异质性分析还表明,SES对潜在转移概率的影响对他们与子女关系的满意度是异质的,以及孩子的数量。此外,决策树分析发现SES和性别可以预测过渡。这些发现增加了有关SES对抑郁症异质性影响的文献,并对抑郁症筛查和识别需要针对性干预的个体具有意义。
    Socioeconomic status\' (SES) impact on depressive symptoms has been extensively examined; however, previous studies have generally used variable-centered approaches and cross-sectional designs. Therefore, this study explored the subtypes of depression and examined the degree of association between SES and latent transition probabilities. We used latent profile and latent transition analyses with the 2015 and 2018 waves of data from the China Health and Retirement Longitudinal Study (N = 4904). Three subtypes of depression were identified based on symptoms: severe symptom (SS), low symptom (LS), and sub-health (MS). The SS subtype had the highest probability of staying within the original subtype. Individuals in the MS subtype were more likely to move to the SS subtype than those in the LS subtype. The heterogeneity analysis also showed that the effect of SES on latent transition probabilities is heterogeneous to the satisfaction with their relationship with their children, as well as the number of children. Additionally, decision tree analysis found SES and gender can predict transitioning. These findings add to literature on the effects of SES on the heterogeneity of depression and have implications for depression screening and identifying individuals in need of targeted interventions.
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  • 文章类型: Journal Article
    认知刺激疗法(CST)被发现可以显着改善英国轻中度痴呆患者的认知功能和生活质量(QOL)。然而,台湾本土对老年痴呆症患者的研究很少。因此,本研究通过一项准实验性试验,开发并调查了台湾版CST组(CST-T)的疗效.不包括辍学者,有13名实验参与者(M=78.9±9.0)和13名对照参与者(77.9±5.6).结果表明认知功能有显著改善,QOL,与对照组相比,实验组的日常生活功能,在3个月的随访中,这些影响仍然很明显。
    Cognitive stimulation therapy (CST) was found to significantly improve cognitive function and quality of life (QOL) in patients with mild-to-moderate dementia in the UK. However, indigenous research on older adults with dementia in Taiwan is scarce. Therefore, this study developed and investigated the effects of a Taiwan version of group CST (CST-T) through a quasi-experimental trial. Excluding the dropouts, there were 13 experimental participants (M = 78.9 ± 9.0) and 13 control participants (77.9 ± 5.6). The results indicated significant improvements in cognitive function, QOL, and daily life functioning in the experimental group compared with the control group, and these effects remained evident at a 3-month follow-up.
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  • 文章类型: Journal Article
    目的:本研究的目的是探讨术前焦虑和抑郁对主观功能的影响。全膝关节置换术(TKA)后的疼痛和翻修率。
    方法:进行了前瞻性比较研究,包括2019年1月至2021年4月期间接受TKA手术的349例患者。患者术前完成医院焦虑和抑郁量表(HADS)问卷,术前和术后6、12和24个月的一组患者报告的结果测量(PROMs)。根据HADS评分将患者分为焦虑和抑郁组。PROM包括膝关节损伤和骨关节炎结果评分-身体功能简表(KOOS-PS),牛津膝关节评分(OKS)和NRS疼痛。焦虑/抑郁组之间的PROM评分差异,分别,评估非焦虑/非抑郁组,以及最小临床重要差异(MCID)和达到患者可接受症状状态(PASS)的差异。最后,比较了翻修率。
    结果:与无焦虑和无抑郁组相比,焦虑和抑郁组在术前和术后表现出较差的主观功能(均p<0.05)。抑郁症患者术前疼痛较多(p<0.001),术后疼痛也较多(均p<0.05).焦虑和抑郁患者达到KOOS-PS的PASS显著减少,OKS和NRS-疼痛(所有p<0.05)。对于所有PROM,达到MCID的患者比例没有差异(所有p>0.060),两组间的翻修率无差异(均P>0.96).
    结论:术前焦虑和抑郁对TKA患者的主观功能和疼痛以及长达2年的随访产生负面影响。两组之间的修订率没有差异,主观功能和疼痛的临床改善无相关差异。
    方法:二级,前瞻性比较研究。
    OBJECTIVE: The aim of this study was to investigate the influence of preoperative anxiety and depression on subjective function, pain and revision rates following total knee arthroplasty (TKA).
    METHODS: A prospective comparative study was conducted, including 349 patients undergoing TKA surgery between January 2019 and April 2021. Patients completed the Hospital Anxiety and Depression Scale (HADS) questionnaire preoperatively, and a set of Patient-Reported Outcome Measures (PROMs) preoperatively and at 6, 12 and 24 months postoperatively. Patients were categorized into anxiety and depression groups based on HADS scores. PROMs included the Knee injury and Osteoarthritis Outcome Score-Physical Function Shortform (KOOS-PS), Oxford Knee Score (OKS) and NRS-Pain. Differences in PROM scores between the anxiety/depression group and, respectively, nonanxiety/nondepression group were assessed, as well as differences in minimal clinical important difference (MCID) and attainment of Patient Acceptable Symptom State (PASS). Lastly, revision rates were compared.
    RESULTS: Anxiety and depression groups exhibited inferior subjective function preoperatively and postoperatively compared to nonanxiety and nondepression groups (all p < 0.05), experienced more pain preoperatively (p < 0.001) and also postoperatively for depression patients (all p < 0.05). Significantly fewer patients with anxiety and depression reached the PASS for KOOS-PS, OKS and NRS-Pain (all p < 0.05). There were no differences in the proportion of patients reaching the MCID for all PROMs (all p > 0.060), and revision rates did not differ between groups (both p > 0.96).
    CONCLUSIONS: Preoperative anxiety and depression negatively influence subjective function and pain preoperatively and up to 2-year follow-up in patients undergoing TKA. Revision rates did not differ between groups, and there were no relevant differences in clinical improvement of subjective function and pain.
    METHODS: Level II, prospective comparative study.
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  • 文章类型: Journal Article
    特发性突发性感觉神经性听力损失(ISSHL)是一种突然发作,原因不明的感觉神经性听力损失.抑郁症是一种常见的精神障碍和残疾的主要原因。这里,我们使用双样本孟德尔随机化方法,使用来自ISSHL全基因组关联研究的汇总统计数据(1491例,196,592名对照)和抑郁症(23,424例,192,220个对照)在欧洲人口中。本研究使用逆方差加权研究了与抑郁症相关的单核苷酸多态性与ISSHL之间的双向关系。额外的敏感性分析,如孟德尔随机化-Egger(MR-Egger),加权中位数估计,和遗漏分析,进行评估结果的可靠性。在随机效应IVW方法中,对ISSHL的遗传易感性与抑郁症之间存在显着因果关系(OR=1.037,95%CI=1.004-1.072,P=0.030)。相比之下,遗传性抑郁不是ISSHL的危险因素(OR=1.134,95%CI=0.871~1.475,P=0.350)。通过不同的MR方法验证和敏感性分析,所有上述结果是一致的。我们收集的证据表明ISSHL与抑郁症之间存在因果关系。前者的存在诱发或进一步加剧后者,而当后者是影响因素时,就不存在类似的情况。
    Idiopathic Sudden Sensorineural Hearing Loss (ISSHL) is a sudden onset, unexplained sensorineural hearing loss. Depression is a common mental disorder and a leading cause of disability. Here, We used a two-sample Mendelian randomization approach using pooled statistics from genome-wide association studies of ISSHL (1491 cases, 196,592 controls) and depression (23,424 cases, 192,220 controls) in European populations. This study investigated the bidirectional relationship between single nucleotide polymorphisms associated with depression and ISSHL using inverse variance weighting.Additional sensitivity analyses, such as Mendelian randomization-Egger (MR-Egger), weighted median estimates, and leave-one-out analysis, were performed to assess the reliability of the findings. Significant causal association between genetic susceptibility to ISSHL and depression in a random-effects IVW approach (OR = 1.037, 95% CI = 1.004-1.072, P = 0.030). In contrast, genetic depression was not risk factors for ISSHL (OR = 1.134, 95% CI = 0.871-1.475, P = 0.350). After validation by different MR methods and the sensitivity analysis, all of the above results are consistent. The evidence we have gathered suggests a causal relationship between ISSHL and depression. The presence of the former induces or further exacerbates the latter, whereas a similar situation does not exist when the latter is an influencing factor.
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  • 文章类型: Journal Article
    目的:本研究旨在利用国家健康与营养调查(NHANES)的数据,分析类风湿性关节炎(RA)与全因死亡率和心血管疾病(CVD)相关死亡率之间的关系,并探讨抑郁症在这些关系中的潜在中介作用。
    方法:从2007年到2016年,在五个NHANES周期中,有19,165名参与者参加了这项研究。RA之间的多因素Cox回归模型,我们构建了抑郁和两种死亡率结局以及RA和抑郁之间的多因素回归模型,以检验它们之间的关联.抑郁症的中介作用也得到了研究。
    结果:本研究中RA的患病率为6.57%,RA患者的全因死亡率为20.57%,CVD相关死亡率为6.12%.在完全调整的模型中,RA与全因死亡率[风险比(HR)=1.28,95%置信区间(CI)=1.12~1.48]和CVD相关死亡率(HR=1.33,95%CI=1.03~1.72)相关,亚组之间没有检测到的相互作用(相互作用P>0.05)。RA也与抑郁症呈正相关。抑郁评分在RA和两种死亡率之间的关系中表现出明显的中介作用,调解率分别为18.2%和18.9%。
    结论:RA的诊断是自我报告的,可能存在回忆偏差。
    结论:RA与全因死亡率和CVD相关死亡率的风险呈正相关。抑郁症部分介导了这些关联。密切关注和积极改善RA患者的心理健康对于降低全因死亡率和CVD相关死亡率至关重要。
    OBJECTIVE: This study aimed to analyze the associations between rheumatoid arthritis (RA) and all-cause mortality and cardiovascular disease (CVD)-related mortality using data from the National Health and Nutrition Examination Survey (NHANES) and examine the potential mediating role of depression in these correlations.
    METHODS: 19,165 participants across five NHANES cycles from 2007 to 2016 participated in this study. Multifactorial Cox regression models between RA, depression and two mortality outcomes and multifactorial regression models between RA and depression were constructed to examine their associations. The mediating role of depression has also been investigated.
    RESULTS: The prevalence of RA in this study was 6.57 %, the all-cause mortality of RA patients was 20.57 %, and the CVD-related mortality was 6.12 %. In the fully adjusted model, RA was associated with all-cause mortality [hazard ratio (HR) = 1.28, 95 % confidence interval (CI) = 1.12 to 1.48] and CVD-related mortality (HR = 1.33, 95 % CI = 1.03 to 1.72), without detectable interaction among subgroups (P for interaction >0.05). RA also had a positive correlation with depression. Depression score demonstrated pronounced mediating effects in the connections between RA and two types of mortality, with mediation ratios of 18.2 % and 18.9 %.
    CONCLUSIONS: The diagnosis of RA is self-reported and may be subject to recall bias.
    CONCLUSIONS: RA was positively correlated with the risk of all-cause mortality and CVD-related mortality. Depression partially mediates these associations. Close attention to and active improvement of mental health in RA patients will be critical to decrease all-cause mortality and CVD-related mortality.
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