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老年人的焦虑与 10 年内新发和复发性抑郁症状的风险。

Anxiety and 10-year risk of incident and recurrent depressive symptomatology in older adults.

机构信息

Centre de recherche de l'Institut universitaire en santé mentale de Québec, Québec, Canada.

出版信息

Depress Anxiety. 2013 Jun;30(6):554-63. doi: 10.1002/da.22101. Epub 2013 Mar 26.

Abstract

BACKGROUND

Anxiety has been shown to often precede depression in children and young adults. Only a small number of investigations have examined this form of comorbidity in older adults and the temporal relationship of these syndromes remains unclear. The objective was to verify whether trait anxiety predicts incident/recurrent depressive symptomatology in older adults independently of variables susceptible to explain this relationship in this population, such as cognitive complaints, subjective health, and baseline depressive symptoms.

METHODS

A random sample of 4,649 individuals aged 65 years or older from the Three-City Study, a prospective longitudinal study with a 10-year follow-up, was used. Incident and recurrent depressive symptomatology were determined by Center for Epidemiological Studies Depression Scale cutoff scores. Anxiety was measured using the trait scale of the State-Trait Anxiety Inventory. Cox proportional hazards models were used to determine the independent risk of depressive symptomatology for baseline anxiety, cognitive complaints, subjective health, and depressive symptoms, adjusting for sociodemographic, mental health, and physical health covariates.

RESULTS

Incident depressive symptomatology was independently predicted by baseline anxiety, depressive symptoms, cognitive complaints, and subjective health. Recurrent depressive symptomatology was independently predicted by baseline anxiety and depressive symptoms, but not by cognitive complaints and subjective health. Anxiety was associated with a higher risk of incident depressive symptomatology only in participants without a history of a major depressive episode, and with a higher risk of recurrent depressive symptomatology in men than in women.

CONCLUSIONS

Trait anxiety constitutes an important independent risk factor for subsequent depressive symptomatology in older adults.

摘要

背景

焦虑症在儿童和青年中常先于抑郁症发生。只有少数研究调查了老年人中这种共病形式,这些综合征的时间关系仍不清楚。目的是验证特质焦虑是否独立于易解释该人群中这种关系的变量(如认知主诉、主观健康和基线抑郁症状)预测老年人的首发/复发性抑郁症状。

方法

使用来自三城市研究的随机样本,该研究是一项具有 10 年随访的前瞻性纵向研究,纳入了 4649 名年龄在 65 岁及以上的个体。使用流行病学研究中心抑郁量表的截断分数来确定首发和复发性抑郁症状。焦虑使用状态-特质焦虑问卷的特质量表进行测量。使用 Cox 比例风险模型确定基线焦虑、认知主诉、主观健康和抑郁症状对抑郁症状的独立风险,调整了社会人口统计学、心理健康和身体健康协变量。

结果

首发抑郁症状独立地由基线焦虑、抑郁症状、认知主诉和主观健康预测。复发性抑郁症状独立地由基线焦虑和抑郁症状预测,而不受认知主诉和主观健康的影响。焦虑与首发抑郁症状的高风险相关,仅在无重大抑郁发作史的参与者中,与男性相比,女性复发性抑郁症状的风险更高。

结论

特质焦虑是老年人随后发生抑郁症状的一个重要独立危险因素。

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