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中文老年人接受初级保健的抑郁障碍的流行率和认知:一项多中心横断面研究。

Prevalence and recognition of depressive disorders among Chinese older adults receiving primary care: A multi-center cross-sectional study.

机构信息

Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, Hubei Province, China; Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, Hubei Province, China.

School of Maxism, China University of Geosciences, Wuhan, Hubei Province, China.

出版信息

J Affect Disord. 2020 Jan 1;260:26-31. doi: 10.1016/j.jad.2019.09.011. Epub 2019 Sep 2.

Abstract

BACKGROUND

In recent years, there have been increasing calls for integrating late-life mental health services into primary care in China, but data on the epidemiology of depressive disorders in older adults receiving primary care are very limited. This study examined prevalence, correlates and recognition of depressive disorders among Chinese older adults receiving primary care.

METHODS

A total of 752 older patients (65+ years) were consecutively recruited from 13 primary care clinics in Wuhan, China, and interviewed with the Chinese Mini-international Neuropsychiatric Interview 5.0.

RESULTS

One-fifth (20.3%) of the older adults met DSM-IV criteria for depressive disorders during the month prior to the interview: 10.2% had major depression, 4.8% had dysthymia, and 5.3% had minor depressive disorder. The recognition rate of older patients with depressive disorders was 1.3% only. In multiple logistic regression analysis, factors significantly associated with depressive disorders included female gender (OR = 1.61), an education of primary school and below (OR = 1.69), poor financial status (OR = 2.44), poor or fair family relationship (OR = 1.66), loneliness (OR = 1.77), hypertension (OR = 1.91), heart disease (OR = 2.02), chronic gastric ulcer (OR = 6.01), and arthritis (OR = 3.55).

LIMITATIONS

Older adults from primary care clinics of economically underdeveloped regions of China were not included.

CONCLUSIONS

Depressive disorders are prevalent but poorly recognized in Chinese older adults receiving treatment in primary care clinics. In order to improve the emotional well-being and health of older adults, it is time to integrate the management of common mental disorders into primary healthcare in China.

摘要

背景

近年来,中国越来越呼吁将老年心理健康服务整合到基层医疗保健中,但关于在接受基层医疗保健的老年人中抑郁障碍的流行病学数据非常有限。本研究调查了在接受基层医疗保健的中国老年人中抑郁障碍的患病率、相关因素和识别情况。

方法

从中国武汉的 13 个基层医疗诊所连续招募了 752 名年龄在 65 岁以上的老年人,并使用中文版 Mini-国际神经精神访谈 5.0 对他们进行了访谈。

结果

在接受访谈前的一个月内,五分之一(20.3%)的老年人符合 DSM-IV 抑郁障碍标准:10.2%患有重性抑郁障碍,4.8%患有心境恶劣障碍,5.3%患有轻度抑郁障碍。只有 1.3%的老年患者被诊断为抑郁障碍。在多因素逻辑回归分析中,与抑郁障碍显著相关的因素包括女性(OR=1.61)、小学及以下文化程度(OR=1.69)、经济状况差(OR=2.44)、家庭关系差或一般(OR=1.66)、孤独(OR=1.77)、高血压(OR=1.91)、心脏病(OR=2.02)、慢性胃溃疡(OR=6.01)和关节炎(OR=3.55)。

局限性

本研究未纳入来自经济欠发达地区基层医疗诊所的老年人。

结论

在中国基层医疗诊所接受治疗的老年人群中,抑郁障碍较为普遍,但识别率较低。为了提高老年人的心理健康和身体健康,现在是时候将常见精神障碍的管理纳入中国的基层医疗保健体系了。

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