INSERM, U912 (SE4S), Marseille, France.
Eur J Public Health. 2009 Dec;19(6):618-24. doi: 10.1093/eurpub/ckp057. Epub 2009 Apr 29.
Depressive disorders have been linked to health risk-related behaviours (HRBs) considered separately. Our objective was to study whether depression is associated with the co-occurrence of HRBs in adults.
A sample of 17 355 subjects aged > or =18 years, derived from the 2002-03 cross-sectional Decennial Health Survey; probable depression was assessed with the CES-D scale. A cluster analysis of various HRBs (tobacco use, alcohol use, binge drinking, physical inactivity, certain eating habits) was used to study their co-occurrence. Multiple regressions adjusted on demographic and socio-economic characteristics, Body Mass Index and chronic illnesses were performed to study associations between probable depression and the HRBs clusters obtained.
Five clusters were observed evidencing a gradient of cumulative exposure to HRBs: 'healthy lifestyles (Cluster 1), 'non-daily-consumers-fruit-and-green-vegetables' (Cluster 2), 'regular alcohol users' (Cluster 3), 'daily smokers' (Cluster 4) and 'cumulate risk takers' (Cluster 5). Compared with Cluster 1, positive associations were found between probable depression and Clusters 2, 4 and 5: OR 1.49 (95% CI 1.26-1.76) for Cluster 2; OR 1.81 (95% CI 1.54-2.12) for Cluster 4; OR 2.05 (95% CI 1.68-2.51) for Cluster 5. For Cluster 3, no association was found: OR 1.01 (95% CI 0.84-1.21).
HRBs tend to co-occur in the general population, more frequently in case of probable depression. Further research is necessary to disentangle the direction of the links between depression and HRB clusters. Nonetheless, these results question the classic design of education campaigns considering HRBs separately. Moreover, screening for depression should be systematic during prevention consultations and various HRBs should be monitored when treating depressive patients.
抑郁障碍与被认为是独立的健康风险相关行为（HRB）有关。我们的目的是研究抑郁是否与成年人中 HRB 的共同发生有关。
从 2002-03 年十年健康调查的横断面研究中抽取了 17355 名年龄大于或等于 18 岁的受试者；使用 CES-D 量表评估可能的抑郁。使用各种 HRB（吸烟、饮酒、狂饮、身体活动不足、某些饮食习惯）的聚类分析来研究它们的共同发生。对人口统计学和社会经济特征、体重指数和慢性疾病进行了多元回归调整，以研究可能的抑郁与获得的 HRB 聚类之间的关联。
观察到五个聚类，表明 HRB 累积暴露程度呈梯度分布：“健康生活方式（聚类 1）”、“非每日消费-水果和蔬菜（聚类 2）”、“规律饮酒者（聚类 3）”、“每日吸烟者（聚类 4）”和“累积风险承担者（聚类 5）”。与聚类 1 相比，可能的抑郁与聚类 2、4 和 5 之间存在正相关：聚类 2 的 OR 为 1.49（95%CI 1.26-1.76）；聚类 4 的 OR 为 1.81（95%CI 1.54-2.12）；聚类 5 的 OR 为 2.05（95%CI 1.68-2.51）。对于聚类 3，未发现关联：OR 为 1.01（95%CI 0.84-1.21）。
HRB 倾向于在人群中共同发生，在可能的抑郁中更频繁。需要进一步研究以厘清抑郁与 HRB 聚类之间的联系方向。尽管如此，这些结果质疑了将 HRB 分开考虑的经典教育运动设计。此外，在预防咨询中应系统地筛查抑郁，在治疗抑郁患者时应监测各种 HRB。
