反复种植失败患者焦虑抑郁症状与情绪调节策略的相关性研究

doi:10.6040/j.issn.1671-7554.0.2024.1436

摘要/Abstract

摘要： 目的探讨反复种植失败患者的焦虑、抑郁症状及其与情绪调节策略(认知重评、表达抑制、反刍)的相关性。方法选取2023年5月5日至2024年11月2日就诊于某三甲生殖专科医院反复种植失败患者300例,采用一般情况调查表、广泛焦虑量表(Generalized Anxiety Disorder-7 items, GAD-7)、患者健康问卷(Patient Health Questionnaire-9 items, PHQ-9)、情绪调节问卷(Emotion Regulation Question-naire, ERQ)、反刍思维反应量表(Ruminative Responses Scale, RRS)进行评估和调查。采用优势分析比较情绪调节策略与PHQ-9得分的相关性。结果反复种植失败患者抑郁评分为5.00(2.00,9.00),焦虑评分为5.00(1.00,7.00),抑郁症状检出率为52.33%,焦虑症状检出率为51.00%。PHQ-9得分在工作情况及婚姻状况方面差异有统计学意义(P<0.05),GAD-7得分在患者备孕胎次方面差异具有统计学意义(P<0.05)。线性回归分析结果表明,反刍和表达抑制与PHQ-9得分正相关(β=0.298,P<0.001; β=0.091,P=0.045),认知重评与PHQ-9得分负相关(β=-0.123,P=0.001),反刍与GAD-7得分正相关(β=0.284,P<0.001);进一步的优势分析显示,反刍、认知重评和表达抑制分别解释抑郁症状93.30%、5.03%和1.84%的方差。结论反复种植失败患者在临床上表现出明显的焦虑、抑郁症状。反刍是导致这两种症状的主要风险因素,认知重评是抑郁症状的保护因素。

关键词: 反复种植失败, 抑郁, 焦虑, 情绪调节策略, 优势分析

Abstract: Objective To investigate the prevalence of anxiety and depression in patients with recurrent implantation failure(RIF)and analyze their associations with emotion regulation strategies(cognitive reappraisal, expressive suppression, rumination). Methods This prospective study enrolled 300 consecutive RIF patients from a tertiary reproductive medicine center(form May 5, 2023 to November 2, 2024). Demographic and baseline clinical characteristics were collected through a structured survey. The Generalized Anxiety Disorder scale(GAD-7)and the Patient Health Questionnaire(PHQ-9)were utilised to evaluate patients anxiety and depression symptoms, respectively. The Emotion Regulation Questionnaire(ERQ)and the Ruminative Response Scale(RRS)were utilised to evaluate three emotion regulation strategies: cognitive reappraisal, expressive suppression, and rumination. Dominance analysis was employed to quantify the relative contributions of emotion regulation strategies to depressive symptoms. Results Patients with recurrent implantation failure had depression scores ranging from 2.00 to 9.00 and anxiety scores from 1.00 to 7.00. The prevalence of depression symptoms was 52.33% and the prevalence of anxiety symptoms was 51.00%. A statistically significant difference was observed in the PHQ-9 scores in relation to work and marital status(P<0.05), and a statistically significant difference was identified in the GAD-7 scores in relation to parity(P<0.05). The findings of the linear regression analysis demonstrated that rumination and expression inhibition exhibited a positive correlation with the PHQ-9 scores(β=0.298,P<0.001; β=0.091,P=0.045), while cognitive reappraisal demonstrated a negative correlation with the PHQ-9 scores(β=-0.123,P=0.001). Additionally, rumination exhibited a positive correlation with the GAD-7 scores(β=0.284,P<0.001). Dominance analysis identified rumination(93.30%), cognitive reappraisal(5.03%), and expressive suppression(1.84%)as key predictors of depressive symptoms. Conclusion RIF patients demonstrate clinically significant anxiety and depression burden. Rumination is the predominant risk factor for both conditions, while cognitive reappraisal serves as a protective mechanism against depression.

Key words: Recurrent implantation failure, Depression, Anxiety, Emotional regulation strategies, Dominance analysis

中图分类号:

R471

孙利静,孟月茹,张召义,刘蕾,马丽瑾,房鹛. 反复种植失败患者焦虑抑郁症状与情绪调节策略的相关性研究[J]. 山东大学学报 (医学版), 2025, 63(10): 89-97.

SUN Lijing, MENG Yueru, ZHANG Zhaoyi, LIU Lei, MA Lijin, FANG Mei. Emotion regulation strategies and psychological distress in recurrent implantation failure patients: a correlational study[J]. Journal of Shandong University (Health Sciences), 2025, 63(10): 89-97.

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