No. 3 Affiliated Hospital of Sun Yat-sen University, No. 600 Tian He Road, Tian He District, Guangzhou, Guangdong 510630, PR China.
J Affect Disord. 2012 Feb;136(3):988-92. doi: 10.1016/j.jad.2011.06.046. Epub 2011 Aug 6.
Years of education are inversely related to the prevalence of major depressive disorder (MDD), but the relationship between the clinical features of MDD and educational status is poorly understood. We investigated this in 1970 Chinese women with recurrent MDD identified in a clinical setting.
Clinical and demographic features were obtained from 1970 Han Chinese women with DSM-IV major depression between 30 and 60 years of age across China. Analysis of linear, logistic and multiple logistic regression models were used to determine the association between educational level and clinical features of MDD.
Subjects with more years of education are more likely to have MDD, with an odds ratio of 1.14 for those with more than ten years. Low educational status is not associated with an increase in the number of episodes, nor with increased rates of co-morbidity with anxiety disorders. Education impacts differentially on the symptoms of depression: lower educational attainment is associated with more biological symptoms and increased suicidal ideation and plans to commit suicide.
Findings may not generalize to males or to other patient populations. Since the threshold for treatment seeking differs as a function of education there may an ascertainment bias in the sample.
The relationship between symptoms of MDD and educational status in Chinese women is unexpectedly complex. Our findings are inconsistent with the simple hypothesis from European and US reports that low levels of educational attainment increase the risk and severity of MDD.
受教育年限与重度抑郁障碍（MDD）的患病率呈负相关，但 MDD 的临床特征与教育程度之间的关系尚不清楚。我们在中国的一个临床环境中对 1970 年的反复发作性 MDD 汉族女性进行了研究。
从中国各地 30 至 60 岁的符合 DSM-IV 重性抑郁障碍的 1970 名汉族女性中获得了临床和人口统计学特征。采用线性、逻辑和多逻辑回归模型分析，以确定教育程度与 MDD 临床特征之间的关系。
受教育年限较长的患者更易患 MDD，受教育年限超过 10 年的患者的优势比为 1.14。低教育程度与发作次数增加无关，也与焦虑障碍共病率增加无关。教育对抑郁症状有不同的影响：受教育程度较低与更多的生物学症状以及自杀意念和自杀计划增加有关。
研究结果可能不适用于男性或其他患者人群。由于治疗寻求的阈值随教育程度的不同而变化，因此样本中可能存在确定偏差。
中国女性 MDD 症状与教育程度之间的关系出人意料地复杂。我们的研究结果与来自欧洲和美国的简单假设不一致，即低教育程度会增加 MDD 的风险和严重程度。
