Guo J, Liu C, Wang X, Qu Z, Zhang W, Zhang X
School of Sociology, Huazhong University of Science and Technology, Wuhan, PR China.
School of Sociology, Huazhong University of Science and Technology, Wuhan, PR China.
Public Health. 2017 Jun;147:30-38. doi: 10.1016/j.puhe.2017.01.031. Epub 2017 Mar 7.
Previous studies have suggested that the high rates of unmet need for mental health services in China among depressed people are related to a cultural tendency to deny mental and emotional symptoms and instead express them somatically. Such somatization may lead a sufferer to a consultation with a healthcare professional but rarely leads to appropriate mental health treatment. This study aimed to elucidate the relationships of depression, sleep quality and perceived physical pain with doctor visits among community-based adults in China, and thus to help guide the development of clinical practices aimed at reducing unmet mental health service need.
Cross-sectional study.
In total, 7602 north-west Chinese adults aged >40 years were included in the survey. The Center for Epidemiologic Studies Depression Scale-Chinese Edition was used to assess depressive symptoms. Subjective sleep quality was evaluated using the Pittsburgh Sleep Quality Index. The Brief Pain Inventory-Chinese Version was used to measure pain severity and pain interference.
In this study, 16.2% of people reported physical pain, and 20.0% of those who reported poor sleep quality had seen a doctor in the past month. Only 14.4% of those with depression had seen a doctor. The results of the logistic regression analyses indicated that subjects with pain were significantly more likely to have seen a doctor than subjects without pain (odds ratio [OR] 1.61; 95% confidence interval [CI] 1.32-1.97). Poor sleep quality was significantly associated with doctor visits (OR 1.76, 95% CI 1.40-2.21). Depression was not associated with doctor visits after adjusting for pain, sleep quality and potentially confounding factors.
When attempting to screen for depression and risk of depression in middle-aged and older adults in China, mental health professionals should focus on perceived physical pain and poor sleep quality.
以往研究表明，中国抑郁症患者对心理健康服务需求未得到满足的比例较高，这与一种文化倾向有关，即否认心理和情绪症状，而是通过躯体症状来表达。这种躯体化现象可能会使患者去咨询医疗专业人员，但很少能获得适当的心理健康治疗。本研究旨在阐明中国社区成年人中抑郁症、睡眠质量和感知到的身体疼痛与就医之间的关系，从而有助于指导旨在减少未得到满足的心理健康服务需求的临床实践的发展。
横断面研究。
总共7602名年龄大于40岁的中国西北成年人被纳入调查。使用流行病学研究中心抑郁量表中文版评估抑郁症状。采用匹兹堡睡眠质量指数评估主观睡眠质量。使用简短疼痛问卷中文版测量疼痛严重程度和疼痛干扰。
在本研究中，16.2%的人报告有身体疼痛，在过去一个月中，报告睡眠质量差的人中有20.0%看过医生。只有14.4%的抑郁症患者看过医生。逻辑回归分析结果表明，有疼痛的受试者比无疼痛的受试者就医的可能性显著更高（比值比[OR]1.61；95%置信区间[CI]1.32 - 1.97）。睡眠质量差与就医显著相关（OR 1.76，95% CI 1.40 - 2.21）。在调整疼痛、睡眠质量和潜在混杂因素后，抑郁症与就医无关。
在中国对中老年人进行抑郁症及抑郁症风险筛查时，心理健康专业人员应关注感知到的身体疼痛和睡眠质量差的情况。
