身体意象失调在库欣综合征患者自我效能与焦虑抑郁间的中介效应OA

Objective To explore the mediating effect of body image disturbance on the relationship between self-efficacy and anxiety-depression in patients with Cushing's syndrome,so as to provide a reference for clinical decision-making.Methods A cross-sectional design was adopted.Through simple random sampling,172 patients with Cushing's syndrome admitted to our hospital from June 2024 to October 2025 were included as survey participants.The Body Image Disturbance Question-naire(BIDQ),General Self-Efficacy Scale(GSES),and Hospital Anxiety and Depression Scale(HADS)were used for as-sessment.The mediating role of body image disturbance between self-efficacy and anxiety-depression in patients with Cush-ing's syndrome was analyzed.Results The total HADS score of the participants was(25.96±5.50)points,the BIDQ score was(23.19±4.48)points,and the GSES score was(21.52±5.66)points.Pearson correlation analysis showed that the BIDQ score was positively correlated with the total HADS score(r=0.789,P<0.001),the GSES score was negatively correlated with the total HADS score(r=-0.805,P<0.001),and the BIDQ score was negatively correlated with the GSES score(r=-0.754,P<0.001).Multiple linear regression analysis showed that annual household income,headache,sleep disturbance,BIDQ score,and GSES score were all factors influencing the total HADS score of the participants(P<0.05).Further hierarchical linear regression analysis showed that after adding BIDQ and GSES scores,the R value and R2 of the model increased markedly,indicating a better regression model.Mediation analysis showed that self-efficacy had a significant effect on body image disturbance(β=-0.5971,P<0.001),and self-efficacy had a significant effect on anxiety-depression(β=-0.7830,P<0.001);both self-efficacy and body image disturbance could predict anxiety-depression(β=-0.4727 and 0.5197,respectively;P<0.001).In patients with Cushing's syndrome,the direct effect of self-efficacy on anxiety-depression accounted for 60.37%of the total effect,while the mediating effect of body image disturbance on the re-lationship between self-efficacy and anxiety-depression accounted for 39.63%.Conclusion Body image disturbance plays a partial mediating role between self-efficacy and anxiety-depression in patients with Cushing's syndrome.Self-efficacy can di-rectly affect anxiety-depression and also indirectly affect anxiety-depression through body image disturbance.Therefore,in clinical psychological interventions,in addition to directly promoting patients'self-efficacy,body image assessment and in-tervention should be prioritized and systematically integrated into routine management processes.