Sale Joanna E M, Gignac Monique, Hawker Gillian
Department of Medicine, Division of Rheumatology, Women's College Hospital, Toronto, Ontario, Canada.
J Rheumatol. 2008 Feb;35(2):335-42. Epub 2008 Jan 15.
The intent of this cross-sectional study was to broaden the range of variables examined in relationship to depression in osteoarthritis (OA) to include comorbidity, stressful life events, and the ways people respond to their disease. We examined the relationship of coping behaviors and perceptions, and medical treatments received for OA and depressive symptoms.
In the fifth year of a prospective cohort study, 1227 individuals >or= 62 years of age with hip/knee OA provided information about sociodemographics (age, sex, living circumstances, education), arthritis severity (WOMAC pain and function; ClinHAQ fatigue), comorbidity, life events, coping behavior, coping efficacy, treatment (pain management, treatment for depression), and depressed mood (Centre for Epidemiological Studies Depression scale, CES-D). Using hierarchical linear regression, variables were entered in blocks to predict CES-D scores. In the final block, the interaction of coping behavior and coping efficacy was tested.
The response rate was 82.4% (n = 1227/1489). The mean CES-D score was 9.4, with 21.3% of individuals scoring >or= 16 (supporting depressed mood). Higher level of depressed mood was independently and significantly associated with being female, experiencing greater pain and fatigue, experiencing stressful life events, more coping behaviors, receiving treatment for depression/mental illness, and a coping behavior by coping efficacy interaction, with 63.4% of the variance accounted for in the model.
Among older adults with OA, the prevalence of depressive symptoms is high. Longitudinal studies must consider OA management strategies, including both the amount of behavioral coping and its perceived efficacy, to elucidate potential interventions designed to reduce depression in patients with OA.
这项横断面研究旨在扩大与骨关节炎（OA）抑郁相关的检查变量范围，纳入合并症、应激性生活事件以及人们应对疾病的方式。我们研究了应对行为和认知与OA及抑郁症状所接受的医学治疗之间的关系。
在一项前瞻性队列研究的第五年，1227名年龄≥62岁的髋/膝OA患者提供了有关社会人口统计学（年龄、性别、生活环境、教育程度）、关节炎严重程度（WOMAC疼痛和功能；ClinHAQ疲劳）、合并症、生活事件、应对行为、应对效能、治疗（疼痛管理、抑郁症治疗）和抑郁情绪（流行病学研究中心抑郁量表，CES-D）的信息。使用分层线性回归，将变量分块输入以预测CES-D分数。在最后一块中，测试了应对行为和应对效能的相互作用。
应答率为82.4%（n = 1227/1489）。CES-D平均得分为9.4，21.3%的个体得分≥16（支持抑郁情绪）。较高水平的抑郁情绪与女性、经历更大疼痛和疲劳、经历应激性生活事件、更多应对行为、接受抑郁症/精神疾病治疗以及应对行为与应对效能的相互作用独立且显著相关，模型中解释了63.4%的方差。
在患有OA的老年人中，抑郁症状的患病率很高。纵向研究必须考虑OA管理策略，包括行为应对的程度及其感知效能，以阐明旨在减少OA患者抑郁的潜在干预措施。
