Determinants of Depressive Symptoms Among Patients with Rheumatoid Arthritis in China: A Structural Equation Model.

IF 2.8 3区 心理学 Q2 PSYCHOLOGY, CLINICAL Psychology Research and Behavior Management Pub Date : 2023-10-17 eCollection Date: 2023-01-01 DOI:10.2147/PRBM.S428892
Lijuan Zhang, Weiyi Zhu, Beiwen Wu
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Abstract

Background: This study aimed to examine how personality traits, social support and clinical features including pain, disease activity, functional status, sleep quality, and fatigue influence on depressive symptoms in Chinese rheumatoid arthritis (RA) patients.

Methods: This study was conducted from November, 2022 to June, 2023 among Chinese RA patients. Pain, disease activity, functional status, sleep quality, fatigue, social support, personality traits, and depressive symptoms were assessed. The following relationships among three hypotheses were analyzed by structural equation model (SEM): H1: clinical features have a direct effect on depressive symptoms; H2: personality traits might work as a mediator between clinical features and depression; H3: social support is related to depressive symptoms, being a direct effect or an indirect effect through clinical features or personality traits.

Results: The final model including 326 RA patients presented a good fit (χ2=103, χ2/df=1.69; GFI=0.96; AGFI=0.93; CFI=0.97; TLI=0.96; RMSEA=0.046). Clinical features had a total effect of 0.59 on depressive symptoms, of which β=0.33 (P=0.013) was an indirect effect through personality traits, indicating a mediating influence between this relationship; moreover, there was a significant direct association between clinical features and depressive symptoms (β=0.26; P=0.022). Personality traits (β=-0.65; P<0.001) had a much stronger relation with depressive symptoms than with clinical features. Social support had a total effect of 0.81 on personality traits, being a direct effect of β=0.52 (P<0.001) and an indirect effect of β=0.29 (P<0.001) through clinical features. The final proposed model explained 77% of the variance of depressive symptoms.

Conclusion: Personality traits had a considerable influence upon depressive symptoms, while social support seemed to have a major effect on personality traits. It is necessary to apply comprehensive assessment and interventions of patients' personality traits, clinical features, as well as social support, which could optimize their mental health.

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中国类风湿性关节炎患者抑郁症状的决定因素:一个结构方程模型。
背景:本研究旨在研究中国类风湿性关节炎(RA)患者的人格特征、社会支持和临床特征(包括疼痛、疾病活动、功能状态、睡眠质量和疲劳)对抑郁症状的影响。方法:本研究于2022年11月至2023年6月在中国RA患者中进行。评估疼痛、疾病活动、功能状态、睡眠质量、疲劳、社会支持、个性特征和抑郁症状。采用结构方程模型分析了三种假设之间的关系:H1:临床特征对抑郁症状有直接影响;H2:人格特征可能是临床特征和抑郁之间的中介;H3:社会支持与抑郁症状有关,是通过临床特征或性格特征产生的直接影响或间接影响。结果:包括326名RA患者的最终模型表现出良好的拟合(χ2=103,χ2/df=1.69;GFI=0.96;AGFI=0.93;CFI=0.97;TLI=0.96,RMSEA=0.046)。临床特征对抑郁症状的总影响为0.59,其中β=0.33(P=0.013)是通过人格特征的间接影响,表明这种关系之间存在中介影响;此外临床特征与抑郁症状之间存在显著的直接相关性(β=0.26;P=0.022)(β=-0.65;P结论:人格特征对抑郁症状的影响较大,而社会支持对人格特征的影响较大。有必要对患者的人格特征、临床特征和社会支持进行综合评估和干预,以优化其心理健康。
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来源期刊
CiteScore
4.50
自引率
4.70%
发文量
341
审稿时长
16 weeks
期刊介绍: Psychology Research and Behavior Management is an international, peer-reviewed, open access journal focusing on the science of psychology and its application in behavior management to develop improved outcomes in the clinical, educational, sports and business arenas. Specific topics covered in the journal include: -Neuroscience, memory and decision making -Behavior modification and management -Clinical applications -Business and sports performance management -Social and developmental studies -Animal studies The journal welcomes submitted papers covering original research, clinical studies, surveys, reviews and evaluations, guidelines, expert opinion and commentary, case reports and extended reports.
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