Buchan Heather, Sunderland Matthew, Carragher Natacha, Louie Eva, Batterham Philip J, Slade Tim
NHMRC Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia.
NHMRC Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia.
Am J Geriatr Psychiatry. 2015 Oct;23(10):1046-55. doi: 10.1016/j.jagp.2015.04.003. Epub 2015 Apr 22.
To investigate factors that may bias the reporting of major depression symptoms among older adults, specifically the presence of physical conditions, bereavement, episode onset, and episode length.
A secondary data analysis of a nationally representative cross-sectional survey of community-dwelling older Australian adults aged 50-85 years who completed the depression module in the 2007 Australian National Survey of Mental Health and Wellbeing (N=629) was conducted. Depression symptomatology was assessed according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria using the World Mental Health Composite International Diagnostic Interview.
Multiple indicators multiple causes modeling indicated a unidimensional factor structure of depression. Two depressive symptoms displayed measurement noninvariance (i.e., nonequivalency): worthlessness/guilt and suicidality/thoughts of death. Specifically, older adults who were bereaved were significantly less likely to report worthlessness/guilt (OR: 0.29; 95% CI: 0.16-0.50) and more likely to report suicidality/thoughts of death (OR: 4.67; 95% CI: 2.84-7.68), compared with older adults who were not bereaved. Examination of latent mean differences revealed that older adults with physical conditions displayed significantly greater depression severity compared with older adults without physical conditions.
The presence of physical conditions and episode onset and length do not appear to differentially influence reporting of depression symptoms among older Australian adults, suggesting these factors do not bias prevalence estimates of depression. Reporting of worthlessness/guilt and suicidality/thoughts of death may be biased toward older adults who are bereaved; however, these did not influence overall depression severity.
探讨可能导致老年人重度抑郁症状报告偏差的因素，特别是身体状况、丧亲之痛、发作起始和发作时长。
对2007年澳大利亚全国心理健康与幸福调查中完成抑郁模块的50 - 85岁社区居住澳大利亚老年人进行全国代表性横断面调查的二次数据分析（N = 629）。根据《精神障碍诊断与统计手册》第四版标准，使用世界心理健康综合国际诊断访谈评估抑郁症状。
多指标多病因模型显示抑郁具有单维因素结构。两种抑郁症状表现出测量非不变性（即不等效性）：无价值感/内疚感和自杀观念/死亡念头。具体而言，与未经历丧亲之痛的老年人相比，经历丧亲之痛的老年人报告无价值感/内疚感的可能性显著降低（比值比：0.29；95%置信区间：0.16 - 0.50），而报告自杀观念/死亡念头的可能性更高（比值比：4.67；95%置信区间：2.84 - 7.68）。潜在均值差异检验显示，有身体状况的老年人与无身体状况的老年人相比，抑郁严重程度显著更高。
身体状况、发作起始和时长似乎并未对澳大利亚老年人抑郁症状的报告产生差异影响，表明这些因素不会使抑郁患病率估计产生偏差。无价值感/内疚感和自杀观念/死亡念头的报告可能偏向于经历丧亲之痛的老年人；然而，这些并未影响总体抑郁严重程度。
