McCusker Jane, Cole Martin, Dufouil Carole, Dendukuri Nandini, Latimer Eric, Windholz Sylvia, Elie Michel
Department of Clinical Epidemiology and Community Studies, St Mary's Hospital, Montreal, Quebec.
J Am Geriatr Soc. 2005 Aug;53(8):1344-53. doi: 10.1111/j.1532-5415.2005.53404.x.
To describe the prevalence of and characteristics associated with major and minor depression in older medical inpatients and to compare associated characteristics by sex and history of depression.
Cross-sectional study of two patient samples, with and without a screening diagnosis of major or minor depression.
The medical services of two acute care hospitals.
Medical admissions of people aged 65 and older with at most mild cognitive impairment (N=380).
Diagnoses of major and minor depression (Diagnostic Interview Schedule), cognitive impairment (Mini-Mental State Examination), premorbid disability, sociodemographic variables (including social networks and support), comorbidity, severity of illness, history of depression.
The prevalence of major depression differed by hospital, ranging from 14.2% (95% confidence interval (CI)=11.7-17.1) in Hospital A to 44.5% (95% CI=33.1-56.4) in Hospital B. The prevalence of minor depression was similar in the two hospitals, ranging from 9.4% (95% CI=7.4-11.9) in Hospital A to 7.9% (95% CI=2.9-16.3) in Hospital B. After adjustment for hospital, the same characteristics (history of depression, premorbid disability, cognitive impairment, perceived adequacy of support, and visits from friends) were associated with major and minor depression, although most of these associations tended to be weaker for minor depression. Most of these factors were also associated with depression in multivariate analyses. The most important characteristics in women were premorbid disability, history of depression, and adequacy of emotional support; in men they were history of depression, cognitive impairment, and adequacy of emotional support. A cerebrovascular or other cardiovascular diagnosis did not explain the association between depression and cognitive impairment.
Major and minor depression occur frequently in older medical inpatients and are associated with similar patient characteristics. A history of depression and the patient's sex should be considered in the identification and interpretation of these associated factors.
描述老年内科住院患者中重度和轻度抑郁症的患病率及相关特征，并按性别和抑郁病史比较相关特征。
对两个患者样本进行横断面研究，一个有重度或轻度抑郁症的筛查诊断，另一个没有。
两家急症医院的医疗服务部门。
65岁及以上且至多有轻度认知障碍的内科住院患者（N = 380）。
重度和轻度抑郁症诊断（诊断访谈表）、认知障碍（简易精神状态检查表）、病前残疾情况、社会人口统计学变量（包括社交网络和支持情况）、合并症、疾病严重程度、抑郁病史。
重度抑郁症的患病率因医院而异，在医院A为14.2%（95%置信区间（CI）= 11.7 - 17.1），在医院B为44.5%（95% CI = 33.1 - 56.4）。轻度抑郁症的患病率在两家医院相似，在医院A为9.4%（95% CI = 7.4 - 11.9），在医院B为7.9%（95% CI = 2.9 - 16.3）。在对医院进行调整后，相同的特征（抑郁病史、病前残疾情况、认知障碍、感知到的支持充足程度以及朋友来访情况）与重度和轻度抑郁症相关，尽管其中大多数关联在轻度抑郁症中往往较弱。在多变量分析中，这些因素中的大多数也与抑郁症相关。女性中最重要的特征是病前残疾情况、抑郁病史以及情感支持的充足程度；男性中则是抑郁病史、认知障碍以及情感支持的充足程度。脑血管或其他心血管疾病诊断并不能解释抑郁症与认知障碍之间的关联。
重度和轻度抑郁症在老年内科住院患者中频繁发生，且与相似的患者特征相关。在识别和解释这些相关因素时应考虑抑郁病史和患者性别。
