To explore the mediating role of mindful attention and awareness in depressive symptoms and insomnia severity among patients with comorbid depression and insomnia.
A cross-sectional study was conducted, enrolling 267 patients with comorbid depression and insomnia who were treated in the outpatient Department of Medical Psychology of Second Affiliated Hospital of Army Medical University, from March to May 2024. Basic demographic and clinical data were collected using a general information questionnaire. Depressive symptom severity was measured via the Patient Health Questionnaire-9 (PHQ-9), insomnia severity via the Insomnia Severity Index (ISI), perceived stress via the Perceived Stress Scale-10 (PSS-10), and mindful attention and awareness via the Mindful Attention Awareness Scale (MAAS). Pearson correlation analysis was used to examine the correlations between depressive severity, insomnia severity, perceived stress, and mindful attention and awareness. Mediation analysis was performed using Process 4.1.
The PHQ-9 score was (13.80±5.98) and the ISI score was (17.10±5.56) in the 267 patients. Pearson correlation analysis showed that depressive severity and insomnia severity were positively correlated with perceived stress (r=0.531, 0.351, P<0.001) and negatively correlated with mindful attention and awareness (r=-0.373, -0.350, P<0.001). Mediation analysis using Process 4.1 indicated that the combined mediating effect of mindful attention and awareness and insomnia between perceived stress level and depressive level was 0.157, with a 95% confidence interval (CI) of 0.102~0.217, and the total mediating effect was significant (P<0.001).
Perceived stress directly positively affects depression and indirectly exacerbates depression through insomnia as a mediator, and mindful attention and awareness can weaken the promoting effect of perceived stress on insomnia.
| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |