Wei Yi-Chia, Huang Li-Yuan, Lin Chemin, Shyu Yu-Chiau, Chen Chih-Ken
Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung, Taiwan.
College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Neuropsychiatr Dis Treat. 2021 Mar 9;17:747-755. doi: 10.2147/NDT.S298233. eCollection 2021.
Major depressive disorder (MDD) presents with emotional and somatic symptoms and sometimes subjective cognitive complaints (SCCs). This study developed a collaborative method to integrate SCC assessment for evaluating late-life MDD.
Residents aged >50 years in the Community Medicine Research Center of Keelung Chang Gung Memorial Hospital in Taiwan during 2017-2018 were prospectively recruited in this study. The participants were asked to report their depressive tendency and SCCs using the Taiwanese Depression Questionnaire (TDQ) and the AD8, respectively, and were administered psychiatric evaluation through the Mini-International Neuropsychiatric Interview (MINI). The participants were divided into elderly (age≥65 years) and older adult (age 50-65) groups. The MDD predictive powers were assessed using logistic regression and receiver operating characteristic (ROC) curve analyses.
Of the 118 enrolled participants (mean age: 64.81±4.99, female-to-male ratio: 1.62), 9, 21, and 88 were categorized as those with current MDD, past MDD, and non-MDD on the basis of the MINI results, respectively. After adjustments for age, sex, and sleep quality, the TDQ score (odds ratio: 1.152, p=0.003) and AD8 score (odds ratio: 1.710, p=0.020) were used individually to predict current MDD. Overall, the TDQ individually predicted current MDD well with area under the ROC curve (AUC) of 0.835 (p=0.001). However, in the elderly group (N=63), the TDQ score did not identify current MDD well (AUC: 0.780, p=0.063). After co-considering SCCs, the linear combination of the sum of the TDQ score and four folds of the AD8 score could effectively distinguished elderly people with current MDD from those without it (AUC: 0.875, p=0.013)-with the cutoff of the aforementioned combined score being ≥32.
The self-reported response to the TDQ is a feasible approach of identifying MDD in community-dwelling people. Combining TDQ and AD8 scores further improved depression detection in elderly people.
重度抑郁症(MDD)表现为情绪和躯体症状,有时还伴有主观认知主诉(SCCs)。本研究开发了一种协作方法,将SCC评估纳入其中,以评估老年期MDD。
2017年至2018年期间,前瞻性招募了台湾基隆长庚纪念医院社区医学研究中心年龄>50岁的居民。参与者分别使用台湾抑郁问卷(TDQ)和AD8报告其抑郁倾向和SCCs,并通过迷你国际神经精神访谈(MINI)进行精神评估。参与者分为老年人(年龄≥65岁)和老年人(年龄50 - 65岁)两组。使用逻辑回归和受试者工作特征(ROC)曲线分析评估MDD的预测能力。
在118名登记参与者中(平均年龄:64.81±4.99,女性与男性比例:1.62),根据MINI结果,分别有9名、21名和88名被归类为当前患有MDD、过去患有MDD和未患MDD的人。在对年龄、性别和睡眠质量进行调整后,TDQ评分(优势比:1.152,p = 0.003)和AD8评分(优势比:1.710,p = 0.020)分别用于预测当前的MDD。总体而言,TDQ单独预测当前MDD的效果良好,ROC曲线下面积(AUC)为0.835(p = 0.001)。然而,在老年组(N = 63)中,TDQ评分对当前MDD的识别效果不佳(AUC:0.780,p = 0.063)。在综合考虑SCCs后,TDQ评分与四倍AD8评分之和的线性组合能够有效区分当前患有MDD的老年人和未患MDD的老年人(AUC:0.875,p = 0.013),上述综合评分的临界值为≥32。
对TDQ的自我报告反应是识别社区居民中MDD的一种可行方法。将TDQ和AD8评分相结合可进一步提高老年人抑郁症的检测率。