Cabello Maria, Borges Guilherme, Lara Elvira, Olaya Beatriz, Martín-Maria Natalia, Moreno-Agostino Dario, Miret Marta, Caballero Francisco Félix, Haro Josep Maria, Ayuso-Mateos José Luis
Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain.
Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, Mexico.
J Affect Disord. 2020 Apr 1;266:424-428. doi: 10.1016/j.jad.2020.01.162. Epub 2020 Jan 28.
Literature has shown that the effect of depression on all-cause mortality is stronger in men. However, it is less clear whether depression affects older and younger people equally. The present study is aimed to analyze whether depression is associated to all-cause mortality in different age and gender groups.
We analyzed a nationally representative sample of the Spanish adult population that was followed-up on for a period of 6 years (n = 4583). Unadjusted and adjusted cox proportional hazard regression models were conducted to test whether baseline depression was associated to all-cause mortality in the total sample and in the different gender and age specific groups, separately.
Unadjusted analyses revealed that depression was associated with higher likelihood of having a shorter survival and dying, in the total sample and in both groups of men (18-64 and 65+ years). However, adjusted analyses stratified by age groups and gender revealed that depression was only a significant factor for all-cause mortality in 18-64 aged men (HR: 6.11; 95%CI= 2.16,17.23).
Cause-specific mortality was not examined. Young adults and middle-aged participants were not analyzed separately.
The depression and all-cause mortality relationship was only found among young and middle-aged men. Further studies should consider whether the significant association between depression and all-cause mortality in young and middle-aged men is due to a behavior of seeking help less, the way depression is shaped in adult men, or to other clinical or health-system related factors.
文献表明，抑郁症对全因死亡率的影响在男性中更为显著。然而，抑郁症对老年人和年轻人的影响是否相同尚不清楚。本研究旨在分析抑郁症是否与不同年龄和性别的全因死亡率相关。
我们分析了西班牙成年人口的全国代表性样本，随访期为6年（n = 4583）。分别在总样本以及不同性别和年龄组中，采用未调整和调整后的Cox比例风险回归模型来检验基线抑郁症是否与全因死亡率相关。
未调整分析显示，在总样本以及两组男性（18 - 64岁和65岁及以上）中，抑郁症与较短生存期和死亡的较高可能性相关。然而，按年龄组和性别分层的调整分析显示，抑郁症仅在18 - 64岁男性的全因死亡率中是一个显著因素（风险比：6.11；95%置信区间 = 2.16, 17.23）。
未检查特定病因死亡率。未分别分析年轻成年人和中年参与者。
仅在年轻和中年男性中发现抑郁症与全因死亡率之间的关系。进一步的研究应考虑年轻和中年男性中抑郁症与全因死亡率之间的显著关联是由于较少寻求帮助的行为、成年男性抑郁症的形成方式，还是其他临床或卫生系统相关因素。
