Discipline of Public Health, University of Adelaide, Adelaide, Australia.
Int Psychogeriatr. 2010 May;22(3):437-44. doi: 10.1017/S1041610209991554. Epub 2010 Jan 28.
Depression is one of the leading contributors to the burden of non-fatal diseases in Australia. Although there is an overall increasing trend in antidepressant use, the relationship between use of antidepressants and depressive symptomatology is not clear, particularly in the older population.
Data for this study were obtained from the Australian Longitudinal Study of Ageing (ALSA), a cohort of 2087 people aged over 65 years at baseline. Four waves of home interviews were conducted between 1992 and 2004 to collect information on sociodemographic and health status. Depressive symptoms were measured by the Center for Epidemiologic Studies - Depression Scale. Use of antidepressants was based on self-report, with the interviewer able to check packaging details if available. Longitudinal analysis was performed using logistic generalized estimating equations to detect if there was any trend in the use of antidepressants, adjusting for potential confounding factors.
The prevalence of depressive symptoms was 15.2% in 1992 and 15.8% in 2004 (p > 0.05). The prevalence of antidepressant users increased from 6.5% to 10.9% (p < 0.01) over this period. Among people with depressive symptoms, less than 20% were taking antidepressants at any wave. Among people without depressive symptoms, the prevalence of antidepressant use was 5.2% in 1992 and 12.0% in 2004 (p < 0.01). Being female (OR = 1.67, 95%CI: 1.25-2.24), having poor self-perceived health status (OR = 1.17, 95%CI: 1.04-1.32), having physical impairment (OR = 1.48, 95%CI: 1.14-1.91) and having depressive symptoms (OR = 1.62, 95%CI: 1.24-2.13) significantly increased the use of antidepressants, while living in community (OR = 0.51, 95%CI: 0.37-0.71) reduced the risk of antidepressant use.
Use of antidepressants increased, while depressive symptoms remained stable, in the ALSA over a 12-year period. Use of antidepressants was low for people with depressive symptoms.
抑郁症是导致澳大利亚非致命性疾病负担的主要原因之一。尽管抗抑郁药的使用总体呈上升趋势，但抗抑郁药的使用与抑郁症状之间的关系尚不清楚，尤其是在老年人群中。
本研究数据来自澳大利亚老龄化纵向研究（ALSA），该研究是一项由 2087 名 65 岁以上基线人群组成的队列研究。在 1992 年至 2004 年间进行了四次家庭访谈，以收集社会人口统计学和健康状况信息。抑郁症状采用流行病学研究中心抑郁量表进行测量。抗抑郁药的使用基于自我报告，如果有包装细节，访谈者可以进行检查。使用逻辑广义估计方程进行纵向分析，以检测抗抑郁药使用是否存在趋势，同时调整潜在的混杂因素。
1992 年抑郁症状的患病率为 15.2%，2004 年为 15.8%（p>0.05）。在此期间，抗抑郁药使用者的比例从 6.5%增加到 10.9%（p<0.01）。在有抑郁症状的人群中，不到 20%的人在任何一阶段都在服用抗抑郁药。在没有抑郁症状的人群中，1992 年抗抑郁药使用率为 5.2%，2004 年为 12.0%（p<0.01）。女性（OR=1.67，95%CI：1.25-2.24）、自我感觉健康状况差（OR=1.17，95%CI：1.04-1.32）、身体功能障碍（OR=1.48，95%CI：1.14-1.91）和抑郁症状（OR=1.62，95%CI：1.24-2.13）显著增加了抗抑郁药的使用，而居住在社区（OR=0.51，95%CI：0.37-0.71）降低了抗抑郁药使用的风险。
在 12 年的时间里，ALSA 中抗抑郁药的使用增加，而抑郁症状保持稳定。有抑郁症状的人群中抗抑郁药的使用率较低。
