Haarasilta Linnea, Marttunen Mauri, Kaprio Jaakko, Aro Hillevi
National Public Health Institute, Department of Mental Health and Alcohol Research, Helsinki, Finland.
Eur J Public Health. 2005 Oct;15(5):489-93. doi: 10.1093/eurpub/cki041. Epub 2005 Jul 19.
This paper aimed to investigate associations between major depressive episode (MDE) and chronic illness, disability, self-perceived health and number of sick-days among adolescents and young adults in the general population.
The Finnish Health Care Survey 1996 was a cross-sectional nationwide epidemiological study. A random sample of 509 adolescents and 433 young adults was interviewed in 1996. DSM-III-R MDE during the past 12 months was defined using The University of Michigan Composite International Diagnostic Interview Short-Form algorithm. Data on physical health were gathered in the interview.
In multivariable logistic regression, chronic illness [odds ratio (OR) 1.78; 95% confidence interval (CI) 1.03, 3.05], poor self-rated health (OR 2.26; 95% CI 1.01, 5.07), more than three sick-days in the past 6 months (OR 1.72; 95% CI 1.02, 2.92) and respiratory allergies (OR 2.40; 95% CI 1.00, 5.75) were associated with MDE. Among 15- to 19-year-olds, disabling chronic illness was related to MDE (OR 2.59; 95% CI 1.06, 6.36), and thoughts of death were more prevalent in the presence of chronic illness among those with MDE [35.2% versus 65.7%; F(1,67) P = 0.024]. Migraine was associated with MDE among young adults (OR 6.18; 95% CI 1.14, 30.8).
Symptoms of depression should be investigated among adolescents with chronic illness or frequent sick-days. The degree of reported disability should be noted. Young people with both chronic illness and depressive symptoms should be assessed for thoughts of death and possible suicidality.
本文旨在调查普通人群中青少年和青年的重度抑郁发作（MDE）与慢性病、残疾、自我感知健康状况及病假天数之间的关联。
1996年芬兰医疗保健调查是一项全国性横断面流行病学研究。1996年，对509名青少年和433名青年进行了随机抽样访谈。使用密歇根大学综合国际诊断访谈简表算法定义过去12个月内的DSM-III-R重度抑郁发作。在访谈中收集身体健康数据。
在多变量逻辑回归分析中，慢性病[比值比（OR）1.78；95%置信区间（CI）1.03，3.05]、自我健康评价差（OR 2.26；95%CI 1.01，5.07）、过去6个月内病假天数超过3天（OR 1.72；95%CI 1.02，2.92）以及呼吸道过敏（OR 2.40；95%CI 1.00，5.75）与重度抑郁发作相关。在15至19岁的青少年中，致残性慢性病与重度抑郁发作有关（OR 2.59；95%CI 1.06，6.36），并且在患有重度抑郁发作的人群中，慢性病患者的死亡念头更为普遍[35.2%对65.7%；F(1,67)P = 0.024]。偏头痛与青年的重度抑郁发作相关（OR 6.18；95%CI 1.14，30.8）。
对于患有慢性病或病假天数频繁的青少年，应调查其抑郁症状。应注意报告的残疾程度。对于患有慢性病和抑郁症状的年轻人，应评估其死亡念头及可能的自杀倾向。
