Ryan Joanne, Carriere Isabelle, Ritchie Karen, Stewart Robert, Toulemonde Gwladys, Dartigues Jean-François, Tzourio Christophe, Ancelin Marie-Laure
Institut National de la Santé et de la Recherche Médicale (INSERM) U888, University of Montpellier, France.
Br J Psychiatry. 2008 Jan;192(1):12-8. doi: 10.1192/bjp.bp.107.039164.
Depression may increase the risk of mortality among certain subgroups of older people, but the part played by antidepressants in this association has not been thoroughly explored.
To identify the characteristics of older populations who are most at risk of dying, as a function of depressive symptoms, gender and antidepressant use.
Adjusted Cox proportional hazards models were used to determine the association between depression and/or antidepressant use and 4-year survival of 7,363 community-dwelling elderly people. Major depressive disorder was evaluated using a standardised psychiatric examination based on DSM-IV criteria and depressive symptoms were assessed using the Center for Epidemiological Studies-Depression scale.
Depressed men using antidepressants had the greatest risk of dying, with increasing depression severity corresponding to a higher hazard risk. Among women, only severe depression in the absence of treatment was significantly associated with mortality.
The association between depression and mortality is gender-dependent and varies according to symptom load and antidepressant use.
抑郁症可能会增加特定老年人群体的死亡风险，但抗抑郁药在这种关联中所起的作用尚未得到充分探讨。
根据抑郁症状、性别和抗抑郁药使用情况，确定死亡风险最高的老年人群体的特征。
采用校正后的Cox比例风险模型，确定7363名社区居住老年人的抑郁和/或抗抑郁药使用与4年生存率之间的关联。使用基于《精神疾病诊断与统计手册》第四版标准的标准化精神检查评估重度抑郁症，并使用流行病学研究中心抑郁量表评估抑郁症状。
使用抗抑郁药的抑郁男性死亡风险最高，抑郁严重程度增加对应更高的风险。在女性中，只有未接受治疗的重度抑郁症与死亡率显著相关。
抑郁与死亡率之间的关联因性别而异，并根据症状负荷和抗抑郁药使用情况而有所不同。
