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Wang L, Liu L, Shi S, Gao J, Liu Y, Li Y, Zhang Z, Wang G, Zhang K, Tao M, Gao C, Li K, Wang X, Lv L, Jiang G, Wang X, Jia H, Zhang J, Lu C, Li Y, Li K, Hu C, Ning Y, Li Y, Sun J, Liu T, Zhang Y, Ha B, Tian H, Meng H, Hu J, Chen Y, Deng H, Huang G, Wu W, Li G, Fang X, Pan J, Hong X, Gao S, Li X, Yang D, Chen G, Liu T, Cai M, Dong J, Mei Q, Shen Z, Pan R, Liu Z, Wang X, Tan Y, Flint J, Kendler KS. Cognitive trio: relationship with major depression and clinical predictors in Han Chinese women. Psychol Med 2013; 43:2265-2275. [PMID: 23425530 PMCID: PMC3807662 DOI: 10.1017/s0033291713000160] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2012] [Revised: 01/06/2013] [Accepted: 01/10/2013] [Indexed: 11/07/2022]
Abstract
BACKGROUND Previous studies support Beck's cognitive model of vulnerability to depression. However, the relationship between his cognitive triad and other clinical features and risk factors among those with major depression (MD) has rarely been systematically studied. METHOD The three key cognitive symptoms of worthlessness, hopelessness and helplessness were assessed during their lifetime worst episode in 1970 Han Chinese women with recurrent MD. Diagnostic and other risk factor information was assessed at personal interview. Odds ratios (ORs) were calculated by logistic regression. RESULTS Compared to patients who did not endorse the cognitive trio, those who did had a greater number of DSM-IV A criteria, more individual depressive symptoms, an earlier age at onset, a greater number of episodes, and were more likely to meet diagnostic criteria for melancholia, postnatal depression, dysthymia and anxiety disorders. Hopelessness was highly related to all the suicidal symptomatology, with ORs ranging from 5.92 to 6.51. Neuroticism, stressful life events (SLEs) and a protective parental rearing style were associated with these cognitive symptoms. CONCLUSIONS During the worst episode of MD in Han Chinese women, the endorsement of the cognitive trio was associated with a worse course of depression and an increased risk of suicide. Individuals with high levels of neuroticism, many SLEs and high parental protectiveness were at increased risk for these cognitive depressive symptoms. As in Western populations, symptoms of the cognitive trio appear to play a central role in the psychopathology of MD in Chinese women.
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Affiliation(s)
- L. Wang
- Shandong Mental Health Center, Jinan, Shandong, P.R. China (P.R.C.)
| | - L. Liu
- Shandong Mental Health Center, Jinan, Shandong, P.R. China (P.R.C.)
| | - S. Shi
- Fudan University Affiliated Huashan Hospital, Shanghai, P.R.C.
| | - J. Gao
- ZheJiang Traditional Chinese Medical Hospital, Hangzhou Zhe Jiang, P.R.C.
| | - Y. Liu
- The First Hospital of China Medical University, He Ping District, Shenyang, Liaoning, P.R.C.
| | - Y. Li
- No. 1 Hospital of Zhengzhou University, Zhengzhou, Henan, P.R.C.
| | - Z. Zhang
- No. 4 Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, P.R.C.
| | - G. Wang
- Beijing Anding Hospital, Capital Medical University, Xicheng District, Beijing, P.R.C.
| | - K. Zhang
- No. 1 Hospital of Shanxi Medical University, Taiyuan, Shanxi, P.R.C.
| | - M. Tao
- Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhe Jiang, P.R.C.
| | - C. Gao
- No. 1 Hospital of Medical College of Xian Jiaotong University, Xi'an, Shaanxi, P.R.C.
| | - K. Li
- Mental Hospital of Jiangxi Province, Jiangxi, P.R.C.
| | - X. Wang
- Shengjing Hospital of China Medical University, Heping District Shenyang, Liaoning, P.R.C.
| | - L. Lv
- Psychiatric Hospital of Henan Province, Xinxiang, Henan, P.R.C.
| | - G. Jiang
- Chongqing Mental Health Center, Chongqing, P.R.C.
| | - X. Wang
- The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, P.R.C.
| | - H. Jia
- Jilin Brain Hospital, Siping, Jilin, P.R.C.
| | - J. Zhang
- No. 3 Affiliated Hospital of Sun Yat-sen University, Tian He District, Guangzhou, Guangdong, P.R.C.
| | - C. Lu
- Shandong Mental Health Center, Jinan, Shandong, P.R. China (P.R.C.)
| | - Y. Li
- Dalian No. 7 People's Hospital & Dalian Mental Health Center, Gan Jing Zi District, Dalian, Liaoning, P.R.C.
| | - K. Li
- Hebei Mental Health Center, Baoding, Hebei, P.R.C.
| | - C. Hu
- No. 3 Hospital of Heilongjiang Province, Beian, Heilongjiang, P.R.C.
| | - Y. Ning
- Guangzhou Brain Hospital/Guangzhou Psychiatric Hospital, Fang Cun Da Dao, Li Wan District, Guangzhou, Guangdong, P.R.C.
| | - Y. Li
- Wuhan Mental Health Center, Wuhan, P.R.C.
| | - J. Sun
- Nanjing Brain Hospital, Nanjing, Jiangsu, P.R.C.
| | - T. Liu
- Shenzhen Kangning Hospital, Luo Hu, Shenzhen, Guangdong, P.R.C.
| | - Y. Zhang
- Lanzhou University Second Hospital, Second Clinical Medical College of Lanzhou University, Lanzhou, Gansu Province, P.R.C.
| | - B. Ha
- No. 4 People's Hospital of Liaocheng, Liaocheng, Shandong, P.R.C.
| | - H. Tian
- Tianjin Anding Hospital, Hexi District, Tianjin, P.R.C.
| | - H. Meng
- No. 1 Hospital of Chongqing Medical University, Yu Zhong District, Chongqing, P.R.C.
| | - J. Hu
- No. 1 Mental Health Center Affiliated Harbin Medical University, Nangang District, Harbin, Heilongjiang, P.R.C.
| | - Y. Chen
- The Fourth Military Medical University Affiliated Xijing Hospital, Xi'an, Shaanxi, P.R.C.
| | - H. Deng
- Mental Health Center of West China Hospital of Sichuan University, Wu Hou District, Chengdu, Sichuan, P.R.C.
| | - G. Huang
- Sichuan Mental Health Center, Mian Yang, Sichuan, P.R.C.
| | - W. Wu
- Shanghai Tongji University Affiliated Tongji Hospital, Shanghai, P.R.C.
| | - G. Li
- Mental Health Institute of Jining Medical College, Dai Zhuang, Bei Jiao, Jining, Shandong, P.R.C.
| | - X. Fang
- Fuzhou Psychiatric Hospital, Cang Shan District, Fuzhou, Fujian, P.R.C.
| | - J. Pan
- The First Affiliated Hospital of Jinan University, Tian He District, Guangzhou, Guangdong, P.R.C.
| | - X. Hong
- Mental Health Center of Shantou University, Wan Ji Industrial Zone, Tai Shan Bei Lu, Shantou, Guangdong, P.R.C.
| | - S. Gao
- Ningbo Kang Ning Hospital, Zhen Hai District, Ningbo, P.R.C.
| | - X. Li
- Anhui Mental Health Center, Hefei, Anhui, P.R.C.
| | - D. Yang
- Jining Psychiatric Hospital, Bei Dai Zhuang, Ren Cheng District, Jining, Shandong, P.R.C.
| | - G. Chen
- Huaian No. 3 Hospital, Huaian, Jiangsu, P.R.C.
| | - T. Liu
- No. 2 Xiangya Hospital of Zhongnan University, Changsha, Hunan, P.R.C.
| | - M. Cai
- Huzhou No. 3 Hospital, Huzhou, Zhejiang, P.R.C.
| | - J. Dong
- Qingdao Mental Health Center, Shibei District, Qingdao, Shandong, P.R.C.
| | - Q. Mei
- Suzhou Guangji Hospital, Suzhou, Jiangsu, P.R.C.
| | - Z. Shen
- Tangshan No. 5 Hospital, Lu Nan District, Tangshan, Hebei, P.R.C.
| | - R. Pan
- Guangxi Longquanshan Hospital, Yu Feng District, Liuzhou, P.R.C.
| | - Z. Liu
- Anshan Psychiatric Rehabilitation Hospital, Li Shan District, Anshan, Liaoning, P.R.C.
| | - X. Wang
- Renmin Hospital of Wuhan University, Wu Chang District, Wuhan, Hubei, P.R.C.
| | - Y. Tan
- Beijing Huilongguan Hospital, Changping District, Beijing, P.R.C.
| | - J. Flint
- Wellcome Trust Centre for Human Genetics, Oxford, UK
| | - K. S. Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
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