Stirland Lucy E, Gregory Sarah, Russ Tom C, Ritchie Craig W, Muniz-Terrera Graciela
Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
J Comorb. 2020 May 5;10:2235042X20920443. doi: 10.1177/2235042X20920443. eCollection 2020 Jan-Dec.
Multimorbidity including physical and mental illness is increasing in prevalence. We aimed to investigate the associations between physical conditions and medication use with anxiety and depression in midlife.
We conducted an observational cross-sectional study of volunteers in the PREVENT Dementia study. Using logistic and linear regression, we investigated the association between increasing numbers of self-reported chronic physical conditions and medications with self-reported depression and anxiety disorder, and scores on the Center for Epidemiologic Studies Depression (CES-D) scale and Spielberger State-Trait Anxiety Inventory (STAI) state subtest.
Of the 210 participants, 148 (71%) were women and 188 (90%) Caucasian. The mean age was 52 (standard deviation (SD) = 5.5) years. The mean number of physical conditions was 2.2 (SD = 1.9) and medications 1.7 (SD = 2.2). Each additional physical condition was associated with increased odds of self-reported depression (odds ratio (OR) 1.41, 95% confidence interval (CI) 1.11-1.80; = 0.004, adjusted for age and gender) and anxiety disorder (OR 1.70, 95% CI 1.30-2.37; 0.001). Increasing medication use was associated with self-reported depression (adjusted OR per additional medication 1.35, 95% CI 1.08-1.71; = 0.008) but not anxiety disorder. For each additional condition, CES-D scores increased by 0.72 (95% CI 0.11-1.33; = 0.020) and for each extra medication, by 0.88 (95% CI 0.32-1.44; = 0.002). There was no significant association between increasing conditions and medications with STAI scores. In models accounting for antidepressant use, all associations were attenuated.
Having more physical conditions is associated with anxiety and depression in midlife, and taking more medications is associated with depression but not anxiety.
包括身体和精神疾病在内的多重疾病的患病率正在上升。我们旨在调查中年时期身体状况和药物使用与焦虑和抑郁之间的关联。
我们对预防痴呆研究中的志愿者进行了一项观察性横断面研究。使用逻辑回归和线性回归，我们调查了自我报告的慢性身体状况和药物数量增加与自我报告的抑郁症和焦虑症之间的关联，以及流行病学研究中心抑郁量表（CES-D）得分和斯皮尔伯格状态-特质焦虑量表（STAI）状态子测试得分。
在210名参与者中，148名（71%）为女性，188名（90%）为白种人。平均年龄为52岁（标准差（SD）=5.5）。身体状况的平均数量为2.2（SD=1.9），药物数量为1.7（SD=2.2）。每增加一种身体状况，自我报告的抑郁症几率增加（优势比（OR）1.41，95%置信区间（CI）1.11-1.80；P=0.004，经年龄和性别调整），焦虑症几率增加（OR 1.70，95%CI 1.30-2.37；P=0.001）。药物使用增加与自我报告的抑郁症相关（每增加一种药物调整后的OR为1.35，95%CI 1.08-1.71；P=0.008），但与焦虑症无关。每增加一种状况，CES-D得分增加0.72（95%CI 0.11-1.33；P=0.020），每增加一种药物，得分增加0.88（95%CI 0.32-1.44；P=0.002）。状况和药物增加与STAI得分之间无显著关联。在考虑抗抑郁药使用的模型中，所有关联均减弱。
中年时期身体状况较多与焦虑和抑郁相关，服用更多药物与抑郁相关，但与焦虑无关。
