CAJ | 학술논문

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一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.
운용잠변량증장곡선모형탐토억욱증환자치료후림상증상적개선정황.대한밀돈억욱량표적체중감경등인자구건비선성조건증장곡선모형,탐토기궤적적발전변화정황급가능영향인소.결과표명초필、인지장애、지완、수면장애증상급억욱총분재치료후적제일차수방시균유현저적개선,수후증상개선교위평완；5개유도인자급억욱총분적절거화사솔인자적방차균유통계학의의,제시환자재치료초기각유도인자균존재개체차이,치료후하강적속도야존재개체차이；성별대5개인자급억욱총분적절거화사솔인자균무영향(P＞0.05)；년령대체중감경、수면장애、억욱총분적절거인자유정방향영향(0.015、0.048、0.068,P＜0.05),혼인대초필인자적절거유정방향영향(0.563,P＜ 0.05),대사솔인자유부방향영향(-0.244,P＜0.05),가족사대지완적절거인자유정방향영향(0.471,P＜0.05)；교육정도대초필화억욱총분적절거인자유부방향영향(-0.424、-0.914,P＜0.05).증장곡선모형불부가이분석종향자료적총체발전추세,이차능대개체간발전추세존재적차이급기원인주출해석,시연구자분석종향자료적유력공구.
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.