Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstr. 1, 85764 Neuherberg, Germany.
Age Ageing. 2012 Mar;41(2):183-90. doi: 10.1093/ageing/afr162. Epub 2011 Dec 11.
prior literature suggests that comorbidity with depression significantly worsens the health state of people with chronic diseases.
the present study examines whether depressed mood increased medical care use for patients with a comorbid physical disease.
DESIGN, SETTING AND SUBJECTS: the study was a population-based study (KORA-Age), with 3,938 participants aged 64-94.
we investigated differences in health services use in participants with and without depressed mood (Geriatric Depression Scale). A further adjustment for disease was done and differences were examined with the Mann-Whitney U test. The incidence rate ratios (IRRs) for doctors' appointments or the number of days in hospital were explored with (zero-inflated) negative binomial regression models.
there are increased self-neglecting behaviours and medical comorbidities in participants with depressed mood. Depressed mood increased participants' use of medical services (P < 0.0001). Among participants who visited the doctor during the last 3 months, those with depressed mood had more visits than those without depressed mood, irrespective of somatic comorbidities (P < 0.0001 and P < 0.05 for ill and healthy, respectively). Additionally, patients with coexisting depressed mood and physical disease visited the doctor's practice significantly more often. Having depressed mood significantly increases the likelihood for more doctor visits (IRR = 1.5, CI = 1.3-1.7) and longer hospital stays (IRR = 1.9, CI = 1.6-2.3). In participants with somatic comorbidities the risk is even greater (IRR = 1.6, CI = 1.3-2, for the number of doctors visits and IRR = 2, CI = 1.4-2.9, for the number of days in the hospital).
results suggest that patients with depressed mood had increased use of health-care services overall, particularly those with somatic comorbidities.
先前的文献表明，抑郁共病显著恶化了患有慢性病的人群的健康状况。
本研究旨在检验抑郁情绪是否会增加患有躯体疾病共病患者的医疗保健使用。
设计、设置和研究对象：该研究是一项基于人群的研究（KORA-Age），共有 3938 名年龄在 64-94 岁的参与者。
我们调查了有和没有抑郁情绪（老年抑郁量表）的参与者在医疗保健使用方面的差异。进一步调整了疾病因素，并使用曼-惠特尼 U 检验进行了差异检验。使用（零膨胀）负二项回归模型探讨了医生就诊次数或住院天数的发生率比（IRR）。
有抑郁情绪的参与者存在更多的自我忽视行为和躯体共病。抑郁情绪增加了参与者对医疗服务的使用（P<0.0001）。在过去 3 个月内就诊的参与者中，有抑郁情绪的人比没有抑郁情绪的人就诊次数更多，无论是否存在躯体共病（分别为 P<0.0001 和 P<0.05）。此外，同时患有抑郁情绪和躯体疾病的患者更频繁地就诊于医生诊所。患有抑郁情绪显著增加了更多就诊的可能性（IRR=1.5，95%CI=1.3-1.7）和更长的住院时间（IRR=1.9，95%CI=1.6-2.3）。在有躯体共病的参与者中，风险甚至更大（就诊次数的 IRR=1.6，95%CI=1.3-2.0；住院天数的 IRR=2，95%CI=1.4-2.9）。
结果表明，有抑郁情绪的患者总体上增加了对医疗保健服务的使用，特别是那些有躯体共病的患者。
