Read Jennifer R, Sharpe Louise, Modini Matthew, Dear Blake F
University of Sydney, Australia.
University of Sydney, Australia.
J Affect Disord. 2017 Oct 15;221:36-46. doi: 10.1016/j.jad.2017.06.009. Epub 2017 Jun 14.
Multimorbidity, the presence of two or more chronic conditions, is increasingly common and complicates the assessment and management of depression. The aim was to investigate the relationship between multimorbidity and depression.
A systematic literature search was conducted using the databases; PsychINFO, Medline, Embase, CINAHL and Cochrane Central. Results were meta-analysed to determine risk for a depressive disorder or depressive symptoms in people with multimorbidity.
Forty articles were identified as eligible (n = 381527). The risk for depressive disorder was twice as great for people with multimorbidity compared to those without multimorbidity [RR: 2.13 (95% CI 1.62-2.80) p<0.001] and three times greater for people with multimorbidity compared to those without any chronic physical condition [RR: 2.97 (95% CI 2.06-4.27) p<0.001]. There was a 45% greater odds of having a depressive disorder with each additional chronic condition compared to the odds of having a depressive disorder with no chronic physical condition [OR: 1.45 (95% CI 1.28-1.64) p<0.001]. A significant but weak association was found between the number of chronic conditions and depressive symptoms [r = 0.26 (95% CI 0.18-0.33) p <0.001].
Although valid measures of depression were used in these studies, the majority assessed the presence or absence of multimorbidity by self-report measures.
Depression is two to three times more likely in people with multimorbidity compared to people without multimorbidity or those who have no chronic physical condition. Greater knowledge of this risk supports identification and management of depression.
共病，即存在两种或更多种慢性病，日益常见，且使抑郁症的评估和管理变得复杂。目的是调查共病与抑郁症之间的关系。
使用以下数据库进行系统的文献检索：心理学文摘数据库（PsychINFO）、医学索引数据库（Medline）、荷兰医学文摘数据库（Embase）、护理学与健康领域数据库（CINAHL）和考科蓝中心对照临床试验注册库（Cochrane Central）。对结果进行荟萃分析，以确定共病患者患抑郁症或出现抑郁症状的风险。
确定了40篇符合条件的文章（n = 381527）。与无共病者相比，共病患者患抑郁症的风险高出两倍[相对危险度（RR）：2.13（95%置信区间1.62 - 2.80），p < 0.001]；与无任何慢性身体疾病者相比，共病患者患抑郁症的风险高出三倍[RR：2.97（95%置信区间2.06 - 4.27），p < 0.001]。与无慢性身体疾病的抑郁症患者相比，每增加一种慢性病，患抑郁症的几率就高出45%[比值比（OR）：1.45（95%置信区间1.28 - 1.64），p < 0.001]。发现慢性病数量与抑郁症状之间存在显著但微弱的关联[r = 0.26（95%置信区间0.18 - 0.33），p < 0.001]。
尽管这些研究使用了有效的抑郁症测量方法，但大多数研究通过自我报告测量来评估共病的存在与否。
与无共病者或无慢性身体疾病者相比，共病患者患抑郁症的可能性高出两到三倍。对这种风险的更多了解有助于抑郁症的识别和管理。
