在老年人中,主要抑郁症和喘结局之间的纵向路径
Jonathan M Feldman1, Kimberly Arcoleo2, Matthew Wysocki3
1Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY; Department of Pediatrics and Department of Psychiatry and Behavioral Sciences, Division of Academic General Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, NY.
The journal of allergy and clinical immunology. In practice
|November 29, 2025
概括
患有喘的老年人患有严重抑郁症 (MDD) 与负面信念和较差的吸入性皮质类固醇 (ICS) 坚持有关. 解决这些信念可能会改善喘的结果,并减少医疗保健的使用.
科学领域:
- 老年学是一门学科.
- 精神病学是一个精神病学.
- 肺部病理学 肺部病理学
背景情况:
- 老年人面临着抑郁症和严重喘并发症的风险增加.
- 大型抑郁症 (MDD) 在这个人口群体中显著影响喘发病率.
研究的目的:
- 研究心理和行为因素在老年人中MDD和喘结果之间纵向关系中的调解作用.
- 确定抑郁症影响喘控制,生活质量和医疗保健利用的特定途径.
主要方法:
- 一项前性队列研究,涉及336名60岁以上的纽约市喘患者成年人.
- 评估MDD,通过电子监视器吸入皮质类固醇 (ICS) 的坚持,喘信念,喘控制,生活质量 (QoL),口服皮质类固醇 (OCS) 的使用和18个月的医疗保健利用情况.
- 隐性变量结构方程建模用于分析纵向数据.
主要成果:
- 多发性喘与更负面的喘感知 (β = 0.31),减少ICS坚持 (β = -0.20) 和增加急诊室 (ED) 访问 (β = 0.15) 有关.
- 负面的喘信念调解了MDD和更糟糕的喘控制 (β = 0.18),较低的QoL (β = -0.22),增加的OCS爆发 (β = 0.10) 和包括ED访问和住院治疗在内的更高的医疗保健利用之间的联系.
结论:
- 在长度上,MDD与负面的喘信念,较差的ICS坚持以及18个月以上的老年人中ED访问的增加有关.
- 关于喘的情绪反应和信念是老年人喘和MDD的干预的关键目标.
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