Williams E D, Tillin T, Richards M, Tuson C, Chaturvedi N, Hughes A D, Stewart R
International Centre for Circulatory Health, Imperial College London,UK.
MRC Unit for Lifelong Health and Ageing, University College London,UK.
Psychol Med. 2015 Jul;45(9):1861-71. doi: 10.1017/S0033291714002967. Epub 2015 Feb 13.
Despite elevated risk profiles for depression among South Asian and Black Caribbean people in the UK, prevalences of late-life depressive symptoms across the UK's three major ethnic groups have not been well characterized.
Data were collected at baseline and 20-year follow-up from 632 European, 476 South Asian and 181 Black Caribbean men and women (aged 58-88 years), of a community-based cohort study from north-west London. The 10-item Geriatric Depression Scale was interviewer-administered during a clinic visit (depressive symptoms defined as a score of ⩾4 out of 10), with clinical data (adiposity, diabetes, cardiovascular disease, cognitive function) also collected. Sociodemographic, psychosocial, behavioural, disability, and medical history information was obtained by questionnaire.
Prevalence of depressive symptoms varied by ethnic group, affecting 9.7% of White European, 15.5% of South Asian, and 17.7% of Black Caribbean participants. Compared with White Europeans, South Asian and Black Caribbean participants were significantly more likely to have depressive symptoms (odds ratio 1.79, 95% confidence interval 1.24-2.58 and 1.80, 1.11-2.92, respectively). Adjustment for co-morbidities had most effect on the excess South Asian odds, and adjustment for socioeconomic position had most effect on the elevated Black Caribbean odds.
Higher prevalence of depressive symptoms observed among South Asian people were attenuated after adjustment for physical health, whereas the Black Caribbean increased prevalence was most explained by socioeconomic disadvantage. It is important to understand the reasons for these ethnic differences to identify opportunities for interventions to address inequalities.
尽管在英国,南亚裔和加勒比黑人患抑郁症的风险较高,但英国三大主要族裔群体中晚年抑郁症状的患病率尚未得到充分描述。
在一项基于伦敦西北部社区的队列研究中,对632名欧洲裔、476名南亚裔和181名加勒比黑人的男性和女性(年龄在58 - 88岁之间)进行了基线和20年随访数据收集。在诊所就诊期间,由访谈员进行10项老年抑郁量表的评估(抑郁症状定义为10分中得分≥4分),同时还收集了临床数据(肥胖、糖尿病、心血管疾病、认知功能)。通过问卷调查获取社会人口统计学、心理社会、行为、残疾和病史信息。
抑郁症状的患病率因种族而异,影响了9.7%的欧洲白人、15.5%的南亚人和17.7%的加勒比黑人参与者。与欧洲白人相比,南亚和加勒比黑人参与者出现抑郁症状的可能性显著更高(优势比分别为1.79,95%置信区间为1.24 - 2.58;以及1.80,1.11 - 2.92)。对合并症进行调整对南亚人的超额优势影响最大,对社会经济地位进行调整对加勒比黑人升高的优势影响最大。
在调整身体健康因素后,南亚人抑郁症状较高的患病率有所降低,而加勒比黑人患病率的升高主要由社会经济劣势来解释。了解这些种族差异的原因对于确定解决不平等问题的干预机会非常重要。