Parc Sanitari Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, 08830 Catalonia, Spain; Centre for Biomedical Research Network on Mental Health, Instituto de Salud Carlos III (CIBERSAM), Madrid, Spain.
Parc Sanitari Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, 08830 Catalonia, Spain; Centre for Biomedical Research Network on Mental Health, Instituto de Salud Carlos III (CIBERSAM), Madrid, Spain.
J Affect Disord. 2020 Sep 1;274:799-805. doi: 10.1016/j.jad.2020.04.020. Epub 2020 May 12.
There is limited research examining the association between perceived stress and depression using large population-based datasets, particularly from low- and middle-income countries (LMICs). Thus, the aim of the study was to assess the association between perceived stress and depression in 45 LMICs.
We analyzed cross-sectional, predominantly nationally representative data from the World Health Survey. A perceived stress score [range 2 (lowest stress) -10 (highest stress)] was computed based on two questions from the Perceived Stress Scale. DSM-IV depression was based on past 12-month symptoms. Multivariable logistic regression analysis (adjusting for sex and age) and meta-analysis were used to examine the associations.
Data on 232,243 adults aged ≥18 years were analyzed. The overall mean (SD) perceived stress score was 4.8 (2.2), while the prevalence of depression was 6.2% (95%CI=5.9%-6.5%). Overall, there was a linear increase in the prevalence of depression with increasing perceived stress scores [i.e., score 2 (1.9%) to score 10 (22.0%)]. Country-wise analysis showed that higher perceived stress levels were significantly associated with increased odds for depression in all countries with the exception of Georgia and Vietnam. The results of the meta-analysis showed that a one-unit increase in the perceived stress score was associated with a 1.40 (95%CI=1.35-1.44) times higher odds for depression.
The cross-sectional nature of the study limits interpretations about causation.
Perceived stress is positively associated with depression across the globe. Future longitudinal and intervention studies from LMICs are warranted to elucidate the potential impact of addressing stress on depression in this setting.
利用大型基于人群的数据集，尤其是来自中低收入国家（LMICs）的数据，研究感知压力与抑郁之间的关联的研究有限。因此，本研究的目的是评估 45 个 LMICs 中感知压力与抑郁之间的关联。
我们分析了来自世界卫生调查的横断面、主要是全国代表性数据。感知压力评分[范围 2（最低压力）-10（最高压力）]是根据感知压力量表中的两个问题计算得出的。DSM-IV 抑郁是基于过去 12 个月的症状。使用多变量逻辑回归分析（调整性别和年龄）和荟萃分析来检验相关性。
分析了 232243 名年龄≥18 岁的成年人的数据。总体平均（SD）感知压力评分是 4.8（2.2），而抑郁的患病率是 6.2%（95%CI=5.9%-6.5%）。总体而言，随着感知压力评分的增加，抑郁的患病率呈线性增加[即评分 2（1.9%）至评分 10（22.0%）]。国家层面的分析表明，除格鲁吉亚和越南外，所有国家的感知压力水平较高与抑郁的几率增加显著相关。荟萃分析的结果表明，感知压力评分增加一个单位，抑郁的几率增加 1.40（95%CI=1.35-1.44）倍。
研究的横断面性质限制了对因果关系的解释。
全球范围内，感知压力与抑郁呈正相关。未来需要来自 LMICs 的纵向和干预研究来阐明在这种情况下，解决压力对抑郁的潜在影响。
