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与社区居住的智利老年人抑郁症状和自我报告的抑郁诊断相关的因素:一项全国性横断面分析。

Factors related to depressive symptoms and self-reported diagnosis of depression in community-dwelling older Chileans: A national cross-sectional analysis.

机构信息

Public Nutrition Unit, The Nutrition and Food Technology Institute (INTA), University of Chile, Santiago, Chile.

Department of Social & Behavioral Sciences, School of Public Health, Yale University, New Haven, Connecticut, USA.

出版信息

Int J Geriatr Psychiatry. 2020 Jul;35(7):749-758. doi: 10.1002/gps.5293. Epub 2020 Mar 20.

DOI:10.1002/gps.5293
PMID:32150304
Abstract

AIM

The aims of this study were to describe the prevalence of screening-positive depression and to identify the frequency and factors related to self-reported depression diagnosis in people with screen-positive depression.

METHODS

Using the Geriatric Depression Scale (GDS-15), 4065 older Chileans were screened for depression. Social and health variables were included. Self-reported depression diagnosis and antidepressant use were analyzed according to screen-positive depression (GDS-15 ≥ 5). Chi-square and logistic regression analyses were conducted to identify factors related to screen-positive depression, and self-reported diagnosis and current antidepressant use.

RESULTS

Overall, mean age was 71.0 years, 60.9% women, and 71.4% had ≤8 years of education. 28.3% of the population screened positive for depression (mild: 21.7%; moderate-severe: 6.5%). Only 35.9% of screen-positive depression individuals self-reported a depression diagnosis (mild: 32.6%; moderate-severe: 47.0%), with significant differences between the sexes (women: 42.2%; men: 22.5%; P < .01). No education (OR = 2.00, 95% CI = 1.20-3.32), multimorbidity (OR = 1.88, 95% CI = 1.42-2.48), dependence (OR = 4.14, 95% CI = 3.11-5.51) and pain (OR = 2.49, 95% CI = 2.01-3.07) were related to screen-positive depression. In people screen-positive depression, men (OR = 0.48, 95% CI = 0.35-0.65) and 80 years or older were less likely to self-report depression diagnosis (OR = 0.35, 95% CI = 0.23-0.54), and current antidepressant use (OR = 0.31, 95% CI = 0.14-0.70).

CONCLUSIONS

A high prevalence of depressive symptoms and low agreement with self-reported depression is observed. There is a need to increase the diagnosis of depression especially in men and people 80 years or older.

摘要

目的

本研究旨在描述筛查阳性抑郁的患病率,并确定筛查阳性抑郁人群中自我报告抑郁诊断的频率和相关因素。

方法

使用老年抑郁量表(GDS-15)对 4065 名智利老年人进行抑郁筛查。纳入社会和健康变量。根据 GDS-15≥5 对自我报告的抑郁诊断和抗抑郁药使用进行分析。采用卡方检验和逻辑回归分析确定与筛查阳性抑郁、自我报告诊断和当前使用抗抑郁药相关的因素。

结果

总体而言,平均年龄为 71.0 岁,60.9%为女性,71.4%的受教育年限≤8 年。28.3%的人群筛查出抑郁(轻度:21.7%;中度-重度:6.5%)。仅有 35.9%的筛查阳性抑郁者自我报告有抑郁诊断(轻度:32.6%;中度-重度:47.0%),性别间存在显著差异(女性:42.2%;男性:22.5%;P<.01)。无教育(OR=2.00,95%CI=1.20-3.32)、多种合并症(OR=1.88,95%CI=1.42-2.48)、依赖(OR=4.14,95%CI=3.11-5.51)和疼痛(OR=2.49,95%CI=2.01-3.07)与筛查阳性抑郁相关。在筛查阳性抑郁人群中,男性(OR=0.48,95%CI=0.35-0.65)和 80 岁及以上者自我报告抑郁诊断的可能性较低(OR=0.35,95%CI=0.23-0.54),且目前使用抗抑郁药的可能性也较低(OR=0.31,95%CI=0.14-0.70)。

结论

本研究观察到抑郁症状的高患病率和自我报告抑郁的低一致性。需要增加抑郁的诊断,特别是在男性和 80 岁及以上的人群中。

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