Kivelä S L, Luukinen H, Sulkava R, Viramo P, Koski K
University of Oulu, Department of Public Health Science and General Practice, Oulu University Hospital, Finland.
J Affect Disord. 1999 Jul;54(1-2):177-82. doi: 10.1016/s0165-0327(98)00143-8.
The aim was to describe the relationships between poor marital and family relations and depression, and the predictive value of these factors for the subsequent occurrence of depression.
The population for the cross-sectional study consisted of the married elderly (N = 498) living in Ahtäri, Finland, in 1989. The series of the longitudinal study was composed of married persons nondepressed in the epidemiological study in 1984-1985, and followed up until 1989-1990 (N = 347).
In men, impaired functional abilities (OR 5.0) and poor family relations (OR 2.9), and in women, impaired functional abilities (OR 3.9), family violence (OR 4.2), age 70 years or over (OR 3.0) and a loss of father in childhood or youth (OR 2.5) were independently related to depression. Poor marital relations tended to be related to depression in both men (OR 2.1) and women (OR 2.2). In both sexes, poor self-appreciation (OR men 3.9; women 7.1) and age 70 years or over (OR men 2.9; women 4.2), and in women, a loss of father in childhood or youth (OR 4.5) were independent predictors of subsequent depression.
The poor marital or family relations experienced by many depressed elderly persons are usually consequences rather than predictors of depression. Family violence may be a consequence of depression or even a risk factor for depression.
Problems in spouse pairs and families should be inquired and solved when treating depressed elderly persons.
Due to the unknown validity of the measure concerning marital relations, the results are suggestive.
目的是描述不良婚姻和家庭关系与抑郁症之间的关系,以及这些因素对随后发生抑郁症的预测价值。
横断面研究的人群包括1989年居住在芬兰阿泰里的已婚老年人(N = 498)。纵向研究系列由1984 - 1985年流行病学研究中未患抑郁症的已婚人士组成,并随访至1989 - 1990年(N = 347)。
在男性中,功能能力受损(比值比5.0)和家庭关系不良(比值比2.9),在女性中,功能能力受损(比值比3.9)、家庭暴力(比值比4.2)、70岁及以上(比值比3.0)以及童年或青年时期父亲去世(比值比2.5)与抑郁症独立相关。不良婚姻关系在男性(比值比2.1)和女性(比值比2.2)中都倾向于与抑郁症相关。在两性中,自我评估差(男性比值比3.9;女性比值比7.1)和70岁及以上(男性比值比2.9;女性比值比4.2),在女性中,童年或青年时期父亲去世(比值比4.5)是随后发生抑郁症的独立预测因素。
许多抑郁症老年人经历的不良婚姻或家庭关系通常是抑郁症的后果而非预测因素。家庭暴力可能是抑郁症的后果甚至是抑郁症的危险因素。
在治疗抑郁症老年人时,应询问并解决配偶和家庭中的问题。
由于婚姻关系测量方法的有效性未知,结果具有提示性。