住院老年人的抑郁及相关因素：沙特一家教学医院的横断面研究
Depression and associated factors in hospitalized elderly: a cross-sectional study in a Saudi teaching hospital.
作者信息
Alamri Sultan Hassan, Bari Abdulaziz Ihsan, Ali Abdulrahman Talal
机构信息
Dr. Sultan Hassan Alamri, King Abdulaziz University,, Abdullah Sulayman,, Jeddah, Makkah, 21441,, Saudi Arabia,
出版信息
Ann Saudi Med. 2017 Mar-Apr;37(2):122-129. doi: 10.5144/0256-4947.2017.122.
BACKGROUND
Depression in the elderly is a serious and often underdiagnosed psychiatric disorder that has been linked to adverse outcomes in the hospital setting.
OBJECTIVES
To determine the prevalence of depression and possible associated factors among hospitalized elderly.
DESIGN
An analytical cross-sectional study.
SETTINGS
Medical and surgical wards of King Abdulaziz University Hospital, Jeddah, Saudi Arabia.
PATIENTS AND METHODS
The study included 200 consecutively hospitalized patients aged 60 years and older. Participants were evaluated within 48 hours of admission using an interviewer-administered question-naire to provide basic demographic and clinical information.
MAIN OUTCOME MEASURE(S): Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9) screening method and the Structured Clinical Interview for the Diagnostic and Statistical Manual, Fifth Edition (DSM-5) mood disorder module.
RESULTS
According to PHQ-9, 17% and 10.5% of the hospitalized patients were diagnosed with a major depressive disorder and other depressive disorders, respectively. The DSM-5 criteria identified 12% of elderly with major depression. Overall, the number of comorbidities associated with depression was signifi-cantly higher in the major depressive disorder group than in the no depression group (post hoc P=.022). Depression was also associated with female gender, unmarried status, lower income, and polypharmacy. In addition, cardiovascular disease and cancer were the most prevalent medical illnesses associated with depression among hospitalized elderly.
CONCLUSION
Major depressive disorder was prevalent among hospitalized elderly, especially among those with comorbid conditions. Hospital physicians must, therefore, maintain a high index of suspicion to identify early and manage depressive symptoms in these patients.
LIMITATION
The small size of certain subgroups limits the statistical power to examine for associations of depression with particular conditions.
背景
老年人抑郁症是一种严重且常被漏诊的精神障碍，与医院环境中的不良后果相关。
目的
确定住院老年人中抑郁症的患病率及可能的相关因素。
设计
一项分析性横断面研究。
地点
沙特阿拉伯吉达阿卜杜勒阿齐兹国王大学医院的内科和外科病房。
患者与方法
该研究纳入了200例年龄在60岁及以上的连续住院患者。参与者在入院后48小时内接受由访谈员执行的问卷调查，以提供基本人口统计学和临床信息。
主要结局指标
使用患者健康问卷-9（PHQ-9）筛查方法和《精神疾病诊断与统计手册》第五版（DSM-5）心境障碍模块的结构化临床访谈来评估抑郁症。
结果
根据PHQ-9，分别有17%和10.5%的住院患者被诊断为重度抑郁症和其他抑郁症。DSM-5标准确定12%的老年人患有重度抑郁症。总体而言，重度抑郁症组中与抑郁症相关的合并症数量显著高于无抑郁症组（事后检验P = 0.022）。抑郁症还与女性、未婚状态、低收入和多种药物治疗相关。此外，心血管疾病和癌症是住院老年人中与抑郁症相关的最常见内科疾病。
结论
重度抑郁症在住院老年人中普遍存在，尤其是那些患有合并症的患者。因此，医院医生必须保持高度的怀疑指数，以便在这些患者中早期识别并管理抑郁症状。
局限性
某些亚组规模较小，限制了检验抑郁症与特定情况之间关联的统计效力。
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