Graduate School of Public Health, Center for Clinical Academia, 5th Floor, St. Luke's International University, Tsukiji 3-6-2, Chuou-ku, Tokyo, 104-0045, Japan.
St. Luke's International Hospital, Tokyo, Japan.
BMC Public Health. 2018 Dec 27;18(1):1406. doi: 10.1186/s12889-018-6327-3.
This study aims to evaluate variation in somatic symptoms by age using patient health questionnaire-9 (PHQ) depression scores, which may be helpful in identifying depression.
The study evaluated a nationally representative cross-sectional sample of community-dwelling adults in Japan in 2013. We utilized the PHQ to identify risk for depression, with PHQ ≥ 10 defining at least moderate depression. Bivariate and factor analyses were used to capture underlying patterns in self-reported symptoms over a 30 day period; aged-stratified multivariate logistic regression was performed to further explore associations between age, symptoms, and depression.
Of 3753 respondents, 296 (8, 95% CI 7.0-8.8) reported a PHQ ≥ 10; 42% of these were male and mean age was 51.7 years old (SD = 18.6). Multivariate analysis showed that presence of fatigue and malaise (OR = 1.7, 95% CI 1.3-2.4) was significantly associated with PHQ ≥ 10. After stratification by age, PHQ ≥ 10 was associated with gastrointestinal complaints among 18-39 year olds (OR = 1.7, 95% CI 1.0-2.9); fatigue and malaise (OR = 1.8, 95% CI 1.1-3.1) among 40-64 year olds; and fatigue and malaise (OR = 1.8, 95% CI 1.1-3.0) as well as extremity pain (OR = 1.7, 95% CI 1.0-2.8) in over 65 year olds.
Age-related somatic symptom correlates of PHQ ≥ 10 differ across the lifespan. Predominantly gastrointestinal symptoms in younger patients, and generalized fatigue, malaise, and musculoskeletal pain in older groups were observed. In order for screening physicians to proactively identify depression, awareness of age-related somatic symptoms is warranted.
本研究旨在使用 PHQ-9（患者健康问卷）抑郁评分评估不同年龄段的躯体症状变化，这有助于识别抑郁。
本研究于 2013 年评估了日本全国范围内具有代表性的社区居住成年人的横断面样本。我们使用 PHQ 来识别抑郁风险，PHQ≥10 定义为至少中度抑郁。使用二变量和因子分析来捕捉 30 天内自我报告症状的潜在模式；使用年龄分层多变量逻辑回归进一步探讨年龄、症状和抑郁之间的关系。
在 3753 名受访者中，有 296 名（8%，95%CI7.0-8.8）报告 PHQ≥10；其中 42%为男性，平均年龄为 51.7 岁（标准差=18.6）。多变量分析显示，疲劳和不适（OR=1.7，95%CI1.3-2.4）的存在与 PHQ≥10 显著相关。按年龄分层后，18-39 岁人群的胃肠道投诉与 PHQ≥10 相关（OR=1.7，95%CI1.0-2.9）；40-64 岁人群的疲劳和不适（OR=1.8，95%CI1.1-3.1）；65 岁以上人群的疲劳和不适（OR=1.8，95%CI1.1-3.0）以及四肢疼痛（OR=1.7，95%CI1.0-2.8）。
PHQ≥10 与年龄相关的躯体症状相关性在整个生命周期中有所不同。在年轻患者中主要表现为胃肠道症状，在老年患者中则表现为全身疲劳、不适和肌肉骨骼疼痛。为了使筛查医生主动识别抑郁，有必要了解与年龄相关的躯体症状。
