Psychological coping in depressed outpatients: Association with cortisol response to the combined dexamethasone/CRH test
Psychological coping in depressed outpatients: Association with cortisol response to the combined dexamethasone/CRH test
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DOI：
10.1016/j.jad.2013.10.013
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发表时间：
2014-01-01
影响因子：
6.6
通讯作者：
Kunugi, Hiroshi
中科院分区：
文献类型：
--
作者：
Hori, Hiroaki;Teraishi, Toshiya;Kunugi, Hiroshi
背景：抑郁症与功能失调的应对方式和下丘脑-垂体-肾上腺（HPA）轴功能失调有关。研究表明，适应不良的应对策略与HPA轴功能异常有关，然而，这种关系在抑郁症患者中的研究还不够。我们的目的是研究是否功能失调的应对方式在抑郁症将与异常皮质醇reactivity.Methods：74例门诊抑郁症患者和133名年龄和性别匹配的健康人被招募。应对方式采用应对方式量表进行评定。采用霍普金斯症状自评量表评估心理困扰。皮质醇反应性测定联合地塞米松/促肾上腺皮质激素释放激素test.Results：与健康人相比，抑郁症患者表现出显着较少使用的问题解决，积极的重新评价和社会支持的应对方式和更多的使用自责和一厢情愿的风格。这种应对方式的模式与患者的更大痛苦显着相关。偏相关分析的患者，控制年龄和性别，揭示了一个显着的相关性，更多的使用逃避回避应对和较低水平的反应性皮质醇的措施。逐步多元回归分析预测皮质醇反应的年龄，性别，痛苦，症状的严重程度和应对方式显示，逃避回避应对是一个显着的predictor.Limitations：神经内分泌挑战测试管理只有一次，基于一个简单的测试protocol.Conclusions：更多地使用逃避回避应对抑郁症患者与皮质醇反应少。我们的研究结果揭示了抑郁症的异质性，低水平和高水平的回避与夸大和钝化HPA轴反应，分别。(C)2013爱思唯尔有限公司版权所有。
Background: Depression is associated with dysfunctional coping styles and dysregulated hypothalamic-pituitary-adrenal (HPA) axis function. Studies have shown that maladaptive coping strategies relate to abnormal HPA axis function; however, such a relationship has been under-studied in patients with depression. We aimed to examine whether dysfunctional coping styles in depression would be associated with abnormal cortisol reactivity.Methods: Seventy-four outpatients with major depressive disorder and 133 age- and sex-matched healthy individuals were recruited. Coping was assessed by the Ways of Coping Checklist. Psychological distress was assessed by the Hopkins Symptom Checklist. Cortisol reactivity was measured by the combined dexamethasone/corticotropin-releasing hormone test.Results: Compared to healthy individuals, depressed patients demonstrated significantly less use of problem-solving, positive reappraisal and social support coping styles and more use of self-blame and wishful thinking styles. Such a pattern of coping styles was significantly associated with patients' greater distress. Partial correlation analysis in patients, controlling for age and sex, revealed a significant correlation between more use of escape-avoidance coping and lower levels of reactive cortisol measures. A stepwise multiple regression analysis predicting cortisol reactivity from age, sex, distress, symptom severity and coping styles revealed that escape-avoidance coping was a significant predictor.Limitations: The neuroendocrine challenge test was administered only once, based on a simple test protocol.Conclusions: More use of escape-avoidance coping in depressed patients was associated with less cortisol reactivity. Our findings shed light on the heterogeneity of depression in terms of low and high levels of avoidance associated with exaggerated and blunted HPA axis reactivity, respectively. (C) 2013 Elsevier B.V. All rights reserved.