| 李丽霞,张岩波,郜艳晖,张敏,周舒冬.抑郁症患者临床症状改善情况的潜变量增长曲线模型研究[J].Chinese journal of Epidemiology,2013,34(8):832-835 |
| 抑郁症患者临床症状改善情况的潜变量增长曲线模型研究 |
| Latent growth curve modeling for improvement of clinical symptoms on depression |
| Received:February 28, 2013 |
| DOI： |
| KeyWord: 潜变量增长曲线模型|汉密顿抑郁量表|纵向数据 |
| English Key Word: Latent growth curve modeling|Hamilton Depression Rating Scale|Longitudinal data |
| FundProject:国家自然科学基金(30972553) |
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| Abstract: |
| 运用潜变量增长曲线模型探讨抑郁症患者治疗后临床症状的改善情况.对汉密顿抑郁量表的体重减轻等因子构建非线性条件增长曲线模型,探讨其轨迹的发展变化情况及可能影响因素.结果表明焦虑、认知障碍、迟缓、睡眠障碍症状及抑郁总分在治疗后的第-次随访时均有显著的改善,随后症状改善较为平缓；5个维度因子及抑郁总分的截距和斜率因子的方差均有统计学意义,提示患者在治疗初期各维度因子均存在个体差异,治疗后下降的速度也存在个体差异；性别对5个因子及抑郁总分的截距和斜率因子均无影响(P＞0.05)；年龄对体重减轻、睡眠障碍、抑郁总分的截距因子有正方向影响(0.015、0.048、0.068,P＜0.05),婚姻对焦虑因子的截距有正方向影响(0.563,P＜0.05),对斜率因子有负方向影响(-0.244,P＜0.05),家族史对迟缓的截距因子有正方向影响(0.471,P＜0.05)；教育程度对焦虑和抑郁总分的截距因子有负方向影响(-0.424、-0.914,P＜0.05).增长曲线模型不仅可以分析纵向资料的总体发展趋势,而且能对个体间发展趋势存在的差异及其原因做出解释,是研究者分析纵向资料的有力工具. |
| English Abstract: |
| To explore the improvement of clinical symptoms after treatment on patients with depression under the latent growth curve modeling.514 patients were studied with Hamilton Depression Rating Scale for depression and nonlinear conditional.Latent growth curve modeling was constructed to assess the features of outcome growth trajectory and possible related influencing factors.Results indicated that the outcome measure showing nonlinear growth trajectory and rapid drop during the first follow-up period and then declining or leveling off for the rest of the observation period on symptoms of anxiety,cognitive disturbance,retardation,sleeping disorder and HAMD scores.The variances of both latent intercept and the slope growth factor were statistically significant,indicating they varied across individuals.Gender did not show significant effect on both the intercept and the slope growth factor for the six outcomes,while age had a significant positive effect on initial weight loss,sleep disorder and HAMD scores at the baseline (0.015,0.048 and 0.068,P＜0.05) survey.Marriage showed significant positive effect on intercept factor of anxiety symptoms (0.563,P＜0.05) but negative effect on slope growth factor (-0.244,P＜0.05) while family history had significant positive effect on intercept factor regarding retardation (0.471,P＜0.05).The level of received education had a significant negative effect on intercept factor of anxiety symptoms and HAMD scores (-0.424 and-0.914,P＜0.05).Latent growth curve models allowed the researchers to study the overall growth trajectory as well as the captured individual differences on these trajectories over time,that also provided a powerful tool for the analysis on longitudinal data. |
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