Blay Sergio Luís, Andreoli Sergio Baxter, Fillenbaum Gerda G, Gastal Fábio Leite
Department of Psychiatry, Federal University of São Paulo, Brazil.
Am J Geriatr Psychiatry. 2007 Sep;15(9):790-9. doi: 10.1097/JGP.0b013e3180654179. Epub 2007 Aug 13.
To investigate the one-month prevalence of depression morbidity and its association with sociodemographic characteristics, health and functional status, and use of health services in community residents aged 60 years and over in Brazil.
This study used a cross-sectional design of face-to-face interviews (N = 7,040) in Rio Grande do Sul State, Brazil. Participants were household residents aged 60 years and older. Measurements included the Short Psychiatric Evaluation Schedule (six-item version) and questionnaire that assessed sociodemographic characteristics, self-reported health status, systemic illnesses, activities of daily living (ADL), use of medical services, and social support.
The overall prevalence of depression morbidity was 22% (men: 18%, women: 25.2%). In controlled analyses, younger age, low income, rural origin, never or no longer married, poor self-rated health, presence of systemic illnesses, visual, hearing, or ADL impairments, hospitalization in the past 12 months, and lack of exercise or employment were significantly associated with depression morbidity, whereas living alone was nearly so associated. Gender, education, minority race, or outpatient visits in the previous six months were not associated with depression morbidity.
The overall prevalence of depression morbidity was among the highest previously reported for older persons. In controlled analyses, prevalence declined as age increased, and rates were higher for those with lower income and poorer social, health, and functional status, but did not differ significantly by gender, education, or race/ethnicity. Increased attention should be paid to identifying depression morbidity in those with adverse circumstances and to identifying ameliorating interventions.
调查巴西60岁及以上社区居民抑郁症发病的1个月患病率及其与社会人口学特征、健康和功能状况以及卫生服务利用情况的关联。
本研究采用在巴西南里奥格兰德州进行面对面访谈的横断面设计（N = 7,040）。参与者为60岁及以上的家庭居民。测量指标包括简短精神评估量表（六项版本）以及评估社会人口学特征、自我报告的健康状况、全身性疾病、日常生活活动（ADL）、医疗服务利用情况和社会支持的问卷。
抑郁症发病的总体患病率为22%（男性：18%，女性：25.2%）。在对照分析中，年龄较小、低收入、农村出身、从未结婚或已不再结婚、自我评定健康状况差、存在全身性疾病、视觉、听力或ADL受损、过去12个月内住院以及缺乏运动或就业与抑郁症发病显著相关，而独居与抑郁症发病几乎也存在关联。性别、教育程度、少数族裔或前六个月的门诊就诊次数与抑郁症发病无关。
抑郁症发病的总体患病率是此前报道的老年人患病率中最高的之一。在对照分析中，患病率随年龄增长而下降，收入较低以及社会、健康和功能状况较差者的患病率较高，但在性别、教育程度或种族/族裔方面无显著差异。应更加关注识别处于不利状况者的抑郁症发病情况，并确定改善干预措施。
