Patten Scott B, Williams Jeanne V A, Lavorato Dina H, Wang Jian Li, Bulloch Andrew G M
1 Department of Community Health Sciences, University of Calgary, Calgary, Alberta.
2 Department of Psychiatry, University of Calgary, Calgary, Alberta.
Can J Psychiatry. 2017 Jan;62(1):62-66. doi: 10.1177/0706743716673323. Epub 2016 Oct 13.
To determine whether there is an association between latitude and annual major depressive episode (MDE) prevalence in Canada.
Data from 2 national survey programs (the National Population Health Survey and the Canadian Community Health Survey) were used, providing 10 data sets collected between 1996 and 2013, together including 922,260 respondents, of whom 495,739 were assessed for MDE using 1 of 2 versions of the Composite International Diagnostic Interview, a short-form version (8 studies), and a Canadian adaptation of the World Mental Health version (2 studies). Approximate latitude was determined by linkage to postal code data. Data were analyzed using logistic regression and pooled across surveys using individual-level meta-analytic methods.
In models including latitude as a continuous variable, a statistically significant association was observed, with prevalence increasing with increasing latitude. This association persisted after adjustment for a set of known risk factors. The latitude gradient was modest in magnitude, a 1% to 2% increase in the prevalence odds of MDE per degree of latitude was observed. Due to sparse data, this gradient cannot be confidently generalized beyond major population centres, which tend to occur at less than 55° latitude in Canada.
A latitude gradient has not previously been reported. If replicated, the gradient may have implications for the planning of services and generation of aetiological hypotheses. However, this cross-sectional analysis cannot confirm aetiology and could not evaluate the potential contributions of variables such as light exposure, weather patterns, or social determinants.
确定加拿大纬度与年度重度抑郁发作(MDE)患病率之间是否存在关联。
使用了来自2个国家调查项目(全国人口健康调查和加拿大社区健康调查)的数据,提供了1996年至2013年期间收集的10个数据集,总共包括922,260名受访者,其中495,739人使用综合国际诊断访谈的2个版本之一进行了MDE评估,一个简短版本(8项研究),以及世界心理健康版本的加拿大改编版(2项研究)。通过与邮政编码数据链接确定近似纬度。使用逻辑回归分析数据,并使用个体水平的荟萃分析方法在各调查中进行汇总。
在将纬度作为连续变量的模型中,观察到具有统计学意义的关联,患病率随纬度增加而增加。在对一组已知风险因素进行调整后,这种关联仍然存在。纬度梯度的幅度适中,观察到纬度每增加一度,MDE患病率比值增加1%至2%。由于数据稀少,这种梯度不能可靠地推广到主要人口中心以外的地区,在加拿大,主要人口中心往往位于纬度低于55°的地方。
此前尚未报道过纬度梯度。如果得到重复验证,该梯度可能对服务规划和病因假设的产生有影响。然而,这种横断面分析不能证实病因,也无法评估光照暴露、天气模式或社会决定因素等变量的潜在贡献。