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老年期焦虑和抑郁的症状特征:移民、宗教和孤独的影响。

Symptom profiles of late-life anxiety and depression: The influence of migration, religion and loneliness.

机构信息

Bamford Centre for Mental Health and Wellbeing, Psychology Research Institute, Ulster University, Coleraine campus, Northern Ireland, UK.

The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland.

出版信息

Depress Anxiety. 2019 Sep;36(9):824-833. doi: 10.1002/da.22893. Epub 2019 Apr 3.

Abstract

OBJECTIVE

To examine (1) clinically relevant anxiety with comorbid depression in an older population, and the presentation of subthreshold symptoms; (2) to assess anxiety and levels of comorbid depression associated with migration, religion, loneliness and long-term illness.

METHODS

Analysis of Wave 1 of The Irish Longitudinal Study on Ageing (TILDA) (2009-2011). Latent class analysis (LCA) was used to define indicative diagnoses of anxiety and depression. We then assessed associations between sociodemographic and socioeconomic factors, past migration, religious practice, social network, loneliness and long-term illness.

RESULTS

For those with clinically relevant anxiety, LCA derived three classes of self-reported depression: low, subthreshold and high. Approximately 19% were comorbid, and a further 37% reported subthreshold depression. Compared to those with low/no symptoms of depression, those classed as comorbid were more likely to be male, had lower education levels, had spent more time abroad, lower religious attendance, a limited social network, were lonelier and had a long-term life-limiting illness. Those with subthreshold levels of depression reported a more restricted social network and more moderate levels of loneliness.

CONCLUSION

Findings support the actuality of comorbidity of both disorders. Consequently, government health strategy on detecting and managing social engagement, loneliness, and psychological disorders in older people may require a more granulated approach.

摘要

目的

在老年人群中研究(1)伴有抑郁共病的临床相关焦虑症,以及亚临床症状的表现;(2)评估与移民、宗教、孤独和长期疾病相关的焦虑和共病抑郁程度。

方法

对爱尔兰老龄化纵向研究(TILDA)(2009-2011 年)的第 1 波数据进行分析。采用潜在类别分析(LCA)来定义焦虑和抑郁的指示性诊断。然后,我们评估了社会人口学和社会经济因素、过去的移民、宗教实践、社交网络、孤独和长期疾病与焦虑和抑郁共病之间的关系。

结果

对于那些有临床相关焦虑症的患者,LCA 得出了三种自我报告的抑郁症类别:低、亚临床和高。大约 19%的患者为共病,另有 37%的患者报告有亚临床抑郁症。与那些没有/低抑郁症状的患者相比,那些被归类为共病的患者更有可能是男性,受教育程度较低,在国外的时间更长,宗教参与度较低,社交网络有限,更孤独,患有长期的生命限制疾病。那些有亚临床抑郁水平的患者报告社交网络更受限,孤独程度更中度。

结论

研究结果支持这两种疾病共病的现实性。因此,政府在检测和管理老年人社会参与、孤独和心理障碍方面的健康战略可能需要采取更细致的方法。

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