Anxiety and Depression as Bidirectional Risk Factors for One Another: A Meta-Analysis of Longitudinal Studies
Anxiety and Depression as Bidirectional Risk Factors for One Another: A Meta-Analysis of Longitudinal Studies
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DOI：
10.1037/bul0000111
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发表时间：
2017-11-01
影响因子：
22.4
通讯作者：
Newman, Michelle G.
中科院分区：
文献类型：
--
作者：
Jacobson, Nicholas C.;Newman, Michelle G.
焦虑和抑郁的诊断不仅倾向于同时出现，而且它们的症状高度相关。虽然大量的研究已经研究了焦虑和抑郁之间的纵向联系，但这些数据还没有被有效地合成。为了满足这一需求，本研究对涉及88,336人的66项研究进行了系统的回顾和荟萃分析，考察了焦虑和抑郁之间在症状和障碍水平上的预期关系。使用混合效应模型，结果表明，所有类型的焦虑症状都预示着后来的抑郁症状(r=.34)，所有类型的抑郁症状都预示着以后的焦虑症状(r=.31)。虽然焦虑症状比抑郁症状更能预测抑郁症状，但这项分析的效果大小差异很小，可能没有临床意义。此外，所有类型的诊断焦虑症预测所有类型的后来抑郁障碍(OR=2.77)，并且所有抑郁障碍预测以后焦虑障碍(OR=2.73)。大多数焦虑和抑郁障碍以相似的强度相互预测，但抑郁障碍对社交焦虑症(OR=6.05)和特定恐惧症(OR=2.93)的预测作用强于相反。与先前综述的结论相反，我们的发现表明，抑郁障碍可能是社交恐惧症和特定恐惧症的先兆，而其他焦虑和抑郁障碍是彼此的双向风险因素。
Not only do anxiety and depression diagnoses tend to co-occur, but their symptoms are highly correlated. Although a plethora of resear ch has examined longitudinal associations between anxiety and depression, these data have not yet been effectively synthesized. To address this need, the current study undertook a systematic review and meta-analysis of 66 studies involving 88,336 persons examining the prospective relationship between anxiety and depression at both symptom and disorder levels. Using mixed-effect models, results suggested that all types of anxiety symptoms predicted later depressive symptoms (r = .34), and all types of depressive symptoms predicted later anxiety symptoms (r = .31). Although anxiety symptoms more strongly predicted depressive symptoms than vice versa, the difference in effect size for this analysis was very small and likely not clinically meaningful. Additionally, all types of diagnosed anxiety disorders predicted all types of later depressive disorders (OR = 2.77), and all depressive disorders predicted later anxiety disorders (OR = 2.73). Most anxiety and depressive disorders predicted each other with similar degrees of strength, but depressive disorders more strongly predicted social anxiety disorder (OR = 6.05) and specific phobia (OR = 2.93) than vice versa. Contrary to conclusions of prior reviews, our findings suggest that depressive disorders may be prodromes for social and specific phobia, whereas other anxiety and depressive disorders are bidirectional risk factors for one another.