McCusker Jane, Cole Martin, Ciampi Antonio, Latimer Eric, Windholz Sylvia, Belzile Eric
Department of Clinical Epidemiology and Community Studies, St. Mary's Hospital, Montreal (Quebec), Canada H3T 1M5.
Gen Hosp Psychiatry. 2007 Jul-Aug;29(4):340-8. doi: 10.1016/j.genhosppsych.2007.03.007.
The aim of this study was to determine the 12-month effects upon physical and mental health status of a diagnosis of major or minor depression among older medical inpatients.
Patients 65 years and older, admitted to the medical wards of two university-affiliated hospitals, with at most mild cognitive impairment, were screened for major and minor depression (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria). All depressed patients and a random sample of nondepressed patients were invited to participate. The physical functioning and mental health subscales of the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) were measured at baseline and at 3, 6 and 12 months.
Two hundred ten patients completed the SF-36 at baseline and at one or more follow-ups. In multiple linear regression analysis for longitudinal data, adjusting for baseline level of the SF-36 subscale outcome, severity of physical illness, premorbid disability, age, sex and other covariates, patients with major depression at baseline had lower SF-36 scores at follow-up, in comparison to patients with no depression [physical health, 9.22 (95% CI -15.52 to -2.93); mental health, 6.28 (95% CI -11.76 to -0.79)].
A diagnosis of major depression in cognitively intact older medical inpatients is associated with sustained poor physical and mental health status over the following 12 months.
本研究旨在确定老年内科住院患者中重度或轻度抑郁症诊断对其身心健康状况的12个月影响。
对两所大学附属医院内科病房收治的65岁及以上、至多有轻度认知障碍的患者进行重度和轻度抑郁症筛查(依据《精神障碍诊断与统计手册》第四版标准)。邀请所有抑郁症患者及非抑郁症患者的随机样本参与研究。在基线时以及3个月、6个月和12个月时测量医学结局研究36项简短健康调查(SF-36)的身体功能和心理健康分量表。
210名患者在基线时以及一次或多次随访时完成了SF-36调查。在对纵向数据的多元线性回归分析中,对SF-36分量表结局的基线水平、身体疾病严重程度、病前残疾情况、年龄、性别及其他协变量进行调整后,与无抑郁症的患者相比,基线时患有重度抑郁症的患者在随访时SF-36得分更低[身体健康,9.22(95%可信区间-15.52至-2.93);心理健康,6.28(95%可信区间-11.76至-0.79)]。
认知功能完好的老年内科住院患者中,重度抑郁症诊断与接下来12个月持续的身心健康状况不佳相关。