Boing Antonio Fernando, Melo Guilherme Rocha, Boing Alexandra Crispim, Moretti-Pires Rodrigo Otávio, Peres Karen Glazer, Peres Marco Aurélio
Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Florianópolis, SC, Brasil.
Rev Saude Publica. 2012 Aug;46(4):617-23. doi: 10.1590/s0034-89102012005000044. Epub 2012 Jun 26.
To assess the association between depression and chronic diseases in adults.
Population-based cross-sectional study with a sample of 1,720 adults aged 20 to 59 years conducted in the city of Florianópolis, southern Brazil, in 2009. Multistage sampling was used and census tracts were the primary sample unit. Subjects were interviewed at home, and reported being diagnosed with depression (outcome) and 11 other chronic diseases (exploratory variable) by a health provider. They were grouped into those with no chronic disease, one, and two or more diseases. Gender, age, marital status, income, physical activity, hospitalization and medical visits were confounders. Poisson regression analysis was used to estimate prevalence ratios and related 95% confidence intervals.
The prevalence of depression was 16.2% (95%CI 14.3;18.2). It was higher in women, older individuals, widowed or divorced, and poor ones. Those who reported no leisure-time physical activity and medical visits in the last two weeks, and who were hospitalized in the last year also showed higher prevalence of depression and chronic diseases. Even after adjustment for confounders the prevalence of depression was 1.44 (95%CI 1.09;1.92) times higher among those reporting one chronic disease and 2.25 times higher among those reporting two or more diseases than among those with no diseases.
The prevalence of depression is much higher among people with higher burden of chronic diseases. Health professionals, health services, and policy makers must target specific strategies to this group.
评估成年人抑郁症与慢性病之间的关联。
2009年在巴西南部弗洛里亚诺波利斯市进行的一项基于人群的横断面研究,样本为1720名年龄在20至59岁之间的成年人。采用多阶段抽样,普查区为主要抽样单位。受试者在家中接受访谈,报告曾被医疗服务提供者诊断为患有抑郁症(结果变量)和其他11种慢性病(探索性变量)。他们被分为无慢性病者、患有一种慢性病者以及患有两种或更多慢性病者。性别、年龄、婚姻状况、收入、身体活动、住院情况和就诊次数为混杂因素。采用泊松回归分析来估计患病率比及相关的95%置信区间。
抑郁症患病率为16.2%(9�%CI 14.3;18.2)。女性、年长者、丧偶或离异者以及贫困者的患病率更高。那些报告在过去两周内没有休闲时间身体活动和就诊,且在过去一年中曾住院的人,抑郁症和慢性病的患病率也更高。即使在对混杂因素进行调整后,报告患有一种慢性病的人群中抑郁症患病率比无慢性病者高1.44倍(95%CI 1.09;1.92),报告患有两种或更多慢性病的人群中抑郁症患病率比无慢性病者高2.25倍。
慢性病负担较重人群中抑郁症患病率要高得多。卫生专业人员、卫生服务机构和政策制定者必须针对这一群体制定具体策略。