Psychology, DEC, Bournemouth University, Dorset BH12 5BB, United Kingdom.
School of Medicine, Dentistry and BioMedical Sciences, Queen's University Belfast, Belfast BT12 6BJ, United Kingdom.
J Affect Disord. 2013 Nov;151(2):632-638. doi: 10.1016/j.jad.2013.07.010. Epub 2013 Jul 29.
Previous research demonstrates various associations between depression, cardiovascular disease (CVD) incidence and mortality, possibly as a result of the different methodologies used to measure depression and analyse relationships. This analysis investigated the association between depression, CVD incidence (CVDI) and mortality from CVD (MCVD), smoking related conditions (MSRC), and all causes (MALL), in a sample data set, where depression was measured using items from a validated questionnaire and using items derived from the factor analysis of a larger questionnaire, and analyses were conducted based on continuous data and grouped data.
Data from the PRIME Study (N=9798 men) on depression and 10-year CVD incidence and mortality were analysed using Cox proportional hazards models.
Using continuous data, both measures of depression resulted in the emergence of positive associations between depression and mortality (MCVD, MSRC, MALL). Using grouped data, however, associations between a validated measure of depression and MCVD, and between a measure of depression derived from factor analysis and all measures of mortality were lost.
Low levels of depression, low numbers of individuals with high depression and low numbers of outcome events may limit these analyses, but levels are usual for the population studied.
These data demonstrate a possible association between depression and mortality but detecting this association is dependent on the measurement used and method of analysis. Different findings based on methodology present clear problems for the elucidation and determination of relationships. The differences here argue for the use of validated scales where possible and suggest against over-reduction via factor analysis and grouping.
先前的研究表明抑郁、心血管疾病（CVD）发病率和死亡率之间存在多种关联，这可能是由于用于测量抑郁和分析关系的方法不同所致。本分析研究了在样本数据集中心境低落与 CVD 发病率（CVDI）和 CVD 死亡率（MCVD）、与吸烟有关的疾病（MSRC）以及所有原因（MALL）之间的关联，在该数据集中心境低落使用经过验证的问卷条目和更大问卷的因子分析得出的条目进行测量，分析是基于连续数据和分组数据进行的。
使用 PRIME 研究（N=9798 名男性）中的抑郁和 10 年 CVD 发病率和死亡率数据，使用 Cox 比例风险模型进行分析。
使用连续数据时，两种抑郁测量方法都得出了抑郁与死亡率之间存在正相关的结果（MCVD、MSRC、MALL）。然而，使用分组数据时，经过验证的抑郁测量方法与 MCVD 之间以及来自因子分析的抑郁测量方法与所有死亡率测量方法之间的关联消失了。
抑郁水平较低、高抑郁水平的个体数量较少以及低水平的结局事件可能会限制这些分析，但对于所研究的人群来说，这些水平是常见的。
这些数据表明抑郁与死亡率之间可能存在关联，但检测到这种关联取决于所使用的测量方法和分析方法。基于方法学的不同发现清楚地提出了阐明和确定关系的问题。这里的差异表明，在可能的情况下应使用经过验证的量表，并建议避免通过因子分析和分组过度简化。
