在社区居住的成年人中,服用抗抑郁药物与人格病理学和生活质量变化之间的关系。

Pub Date : 2024-01-01 DOI:10.3233/JRS-230016
Jeffrey R Vittengl, Robin B Jarrett, Eunyoe Ro, Lee Anna Clark
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引用次数: 0

摘要

背景:尽管在随机对照试验中,抗抑郁药物(ADM)与安慰剂相比优势很小,但在社区居住的成年人样本中,服用抗抑郁药物可预测抑郁症状严重程度的前瞻性增加:我们对社区文献进行了扩展,测试了ADM与人格和生活质量变化的关系,这些变化可能是抑郁症的基础:在这项纵向观察研究中,我们对居住在社区的成年人(N = 601)进行了两次评估,平均相隔 8 个月。评估内容包括抑郁症状、性格、生活满意度和质量以及处方药服用量:在对年龄、性别、种族、收入、教育程度、身体健康问题和其他精神药物的使用情况进行调整之前和之后,在第一时间服用 ADM 可预测抑郁症状(焦虑症)、适应不良特征(消极情绪、消极气质、抑制、低自觉性)、人格功能障碍(不合群、自我病理学)的相对增加,以及从第一时间到第二时间生活满意度和质量的下降。在任何分析中,使用ADM都不能预测更好的结果:结论:在社区居住的成年人中,使用 ADM 是导致社会心理恶化的风险因素,包括抑郁症状、人格病理学和生活质量。在了解 ADM 与社区样本中不良后果之间的关联机制之前,应谨慎使用 ADM,并考虑使用经验支持的非药物治疗方法。
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Associations of antidepressant medication consumption with changes in personality pathology and quality of life among community-dwelling adults.

Background: Although antidepressant medication (ADM) has produced small advantages over pill placebo in randomized controlled trials, consuming ADM has predicted prospectively increasing depressive symptom severity in samples of community-dwelling adults.

Objective: We extended the community literature by testing ADM's relations to changes in personality and quality of life that may underpin depression.

Method: In this longitudinal, observational study, community-dwelling adults (N = 601) were assessed twice, 8 months apart on average. Assessments included depressive symptoms, personality, life satisfaction and quality, and prescription medication consumption.

Results: Consuming ADM at time 1 predicted relative increases in depressive symptoms (dysphoria), maladaptive traits (negative affect, negative temperament, disinhibition, low conscientiousness), personality dysfunction (non-coping, self-pathology), and decreases in life satisfaction and quality from time 1 to 2, before and after adjustment for age, gender, race, income, education, physical health problems, and use of other psychotropics. In no analysis did ADM use predict better outcomes.

Conclusion: Among community-dwelling adults, ADM use is a risk factor for psychosocial deterioration in domains including depressive symptoms, personality pathology, and quality of life. Until mechanisms connecting ADM to poor outcomes in community samples are understood, additional caution in use of ADM and consideration of empirically supported non-pharmacologic treatments is prudent.

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