Aged Mental Health Research Unit, Monash University, Kingston Centre, Warrigal Road, Cheltenham, VIC 3192, Australia.
J Affect Disord. 2012 Dec 15;142(1-3):290-6. doi: 10.1016/j.jad.2012.05.019. Epub 2012 Aug 17.
While depression is common in residential aged care settings, there is an absence of research into factors that may be associated with this condition. This pilot study examined the relationship between depression and multiple biopsychosocial factors among residents of aged care facilities.
Participants were 50 aged care residents with a diagnosis of major depressive disorder, based on a clinical assessment using the SCID-I, and a matched sample of 50 residents without depression. The sample consisted of 80 women and 20 men without significant cognitive impairment, with a mean age of 83.0 years (SD=7.2 years). Participants completed a diagnostic interview with a clinical psychologist to determine the presence or absence of a mood disorder, and a set of scales related to demographics, depressive symptoms, physical health, functional disability, religiosity, and psychological wellbeing.
The unique predictors of scores on the Geriatric Depression Scale-15 were environmental mastery, purpose in life, and autonomy. These three variables discriminated between participants with and without a diagnosis of MDD with 80% accuracy.
Findings were limited by the cross-sectional methodology and small sample size of cognitively intact English-speaking aged care residents. Replication is required with a prospective longitudinal design with a broader sample of residents.
Psychological variables were more important in understanding depression among aged care residents than traditional risk factors such as medical illness and disability. While preliminary, these findings highlight possible targets to prevent and treat depression in aged care settings.
虽然抑郁在养老院环境中很常见，但对于可能与之相关的因素的研究却很少。本初步研究考察了养老院居民的抑郁与多种生物心理社会因素之间的关系。
参与者为 50 名被诊断患有重度抑郁症的养老院居民，他们的诊断是根据 SCID-I 进行临床评估得出的，另外还有 50 名没有抑郁的匹配样本。样本包括 80 名女性和 20 名男性，他们没有明显的认知障碍，平均年龄为 83.0 岁（SD=7.2 岁）。参与者接受了临床心理学家的诊断访谈，以确定是否存在情绪障碍，并完成了一套与人口统计学、抑郁症状、身体健康、功能障碍、宗教信仰和心理健康有关的量表。
老年抑郁量表-15 评分的独特预测因素是环境掌控、生活目标和自主性。这三个变量以 80%的准确率区分了有和没有 MDD 诊断的参与者。
研究结果受到认知完整的英语养老院居民的横断面方法和小样本量的限制。需要采用前瞻性纵向设计和更广泛的居民样本进行复制。
与医疗疾病和残疾等传统危险因素相比，心理变量在理解养老院居民的抑郁方面更为重要。尽管初步结果，但这些发现强调了在养老院环境中预防和治疗抑郁的可能目标。
