重性抑郁障碍患者社会支持与抑郁症状的关系：共情的作用路径

Relationship between social support and depression symptoms in patients of major depressive disorder: the pathway of empathy

投稿时间：2024-08-09 修订日期：2024-11-26

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中文关键词: 抑郁社会支持共情中介作用

英文关键词:Depressive Social Support Empathy Mediating Role

基金项目:

作者	单位	地址
朱兰	天津大学教育学院天津	北京市丰台区新村街道范家庄路8号院26楼1004
李洁^*	天津市安定医院	天津市河西区柳林路13号天津市安定医院
李美娟	天津市安定医院
高营	天津市安定医院

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中文摘要:

背景既往研究表明，社会支持有助于缓解抑郁症患者的抑郁症状并提高个体的共情水平。共情水平越高，抑郁症状发生概率越低。目前，关于重性抑郁障碍（MDD）患者社会支持、共情能力和抑郁症状的关系尚不明确。目的探讨共情在MDD患者社会支持和抑郁症状之间的作用路径，为MDD患者的临床治疗提供参考。方法选取2020年7月—2022年9月在天津市安定医院精神科门诊和心理门诊就诊的、符合《精神障碍诊断与统计手册（第5版）》（DSM-5）MDD诊断标准的126例患者为研究对象。采用汉密尔顿抑郁量表17项版（HAMD-17）、人际反应指针量表（IRI）和社会支持评定量表（SSRS）进行评定。采用Pearson相关分析考查各量表评分间的相关性。采用Process v3.4.1插件的模型4进行作用路径分析，采用Bootstrap法检验作用路径。结果 MDD患者HAMD-17总评分与IRI总评分、幻想维度和个人悲伤维度评分均呈正相关（r=0.225、0.213、0.220，P均<0.05），HAMD-17总评分与SSRS总评分、主观支持维度和支持利用度维度评分均呈负相关（r=-0.211、-0.181、-0.208，P均<0.05）；SSRS支持利用度维度评分与IRI总评分、观点采择和共情关注维度评分均呈正相关（r=0.257、0.261、0.331，P均<0.01）。共情是支持利用度与抑郁症状之间的作用路径，间接效应值为0.217（95% CI：0.060~0.426），效应量为36.90%。结论共情可能是MDD患者支持利用度与抑郁症状之间的作用路径。

英文摘要:

Background Previous studies have shown that social support can alleviate depressive symptoms of depression patients and enhance an individual’s empathy levels. Higher empathy levels are associated with a lower likelihood of experiencing depressive symptoms. Currently, the relationship between social support, empathy, and depressive symptoms in patients with major depressive disorder (MDD) remains unclear. Objective To explore the effecting path of empathy in the relationship between social support and depressive symptoms in patients with MDD, so as to provide references for clinical treatment of MDD patients. Methods A total of 126 patients with MDD who met the diagnostic criteria for MDD according to the Diagnostic and Statistical Manual of Mental Disorders, fifth edition(DSM-5) were selected as subjects. These patients were treated at the psychiatric and psychological outpatient departments of Tianjin Anding Hospital from July 2020 to September 2022. Hamilton Depression Scale-17 item (HAMD-17), Interpersonal Reactivity Index (IRI) and Social Support Rating Scale (SSRS) were used for assessment. Pearson correlation analysis was conducted to examine the correlations among the scale scores. Path analysis was performed using Model 4 of the Process v3.4.1 plugin and the bootstrap method was used to test the effecting path. Results Among MDD patients, the total HAMD-17 score was positively correlated with the total IRI score and its subscales of fantasy and personal distress (r=0.212, 0.196, 0.183, P<0.05). The total HAMD-17 score was negatively correlated with the total SSRS score and its subscales of subjective support and support utilization (r=-0.211, -0.181, -0.208, P<0.05). The score of support utilization subscale of SSRS was positively correlated with the total IRI score and its subscale of perspective taking and empathic concern (r=0.257, 0.261, 0.331, P<0.01). Empathy served as a effecting path between support utilization and depressive symptoms, with an indirect effect of 0.217 (95% CI: 0.060~0.426) and an effect size of 36.90%. Conclusion Empathy may serve as the pathway between support utilization and depressive symptoms in patients with MDD.

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