Division of Epidemiology, Institute of Health and Equity, Graduate School of Biomedical Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin.
Division of General Internal Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, Wisconsin.
Womens Health Issues. 2021 Jul-Aug;31(4):353-365. doi: 10.1016/j.whi.2021.02.005. Epub 2021 Mar 30.
We aimed to examine age and gender differences in the relationship between depression and quality of life among United States adults.
Medical Expenditure Panel Survey data for 2008 to 2016 on 227,663 adults were analyzed. The dependent variable, quality of life, included physical component summary scores and mental component summary scores from the Short Form Health Survey. The key independent variable, depression, was measured using the two-item Patient Health Questionnaire. General linear regression models examined the relationship between quality of life and depression. Models were adjusted for individual and environmental characteristics, symptom status, functional and biological status, and health perceptions and were stratified by gender and age.
In adjusted models, mental component summary scores were significantly lower among those with depression compared with those without depression (β = -0.39; 95% confidence interval [CI], 0.38 to -1.16) and lower among women compared with men (β = -0.10; 95% CI, 0.10 to -1.31). Models stratified by gender and age found women with depression ages 40 to 64 (β = -0.07; 95% CI, 0.07 to -0.20) and 65 or older (β = -0.08; 95% CI, 0.08 to -0.24) had significantly lower physical component summary scores compared with those without depression. Among men with depression, those ages 18 to 39 (β = -0.03; 95% CI, 0.03 to -0.10) and 40 to 64 (β = -0.09, 95% CI, 0.08 to -0.26) had lower physical component summary scores compared with those without depression. Women and men of all ages with depression had significantly lower mental component summary scores compared with those without depression.
Public health interventions and clinical approaches to address depression in women and men should target functional status in men and perceptions of health in women.
本研究旨在探究美国成年人中抑郁与生活质量的关系在年龄和性别上的差异。
我们分析了 2008 年至 2016 年间来自 227663 名成年人的医疗支出面板调查数据。因变量为生活质量，包括来自健康调查短表的身体成分综合评分和精神成分综合评分。关键自变量为抑郁，使用 PHQ-2 进行测量。一般线性回归模型用于检验生活质量与抑郁之间的关系。模型调整了个体和环境特征、症状状况、功能和生物状况以及健康认知，并按性别和年龄进行分层。
在调整后的模型中，与无抑郁者相比，抑郁者的精神成分综合评分显著更低（β=-0.39；95%置信区间，0.38 至-1.16），女性的评分比男性更低（β=-0.10；95%置信区间，0.10 至-1.31）。按性别和年龄分层的模型发现，40 至 64 岁（β=-0.07；95%置信区间，0.07 至-0.20）和 65 岁及以上（β=-0.08；95%置信区间，0.08 至-0.24）的女性抑郁患者的身体成分综合评分显著更低。在抑郁男性中，18 至 39 岁（β=-0.03；95%置信区间，0.03 至-0.10）和 40 至 64 岁（β=-0.09；95%置信区间，0.08 至-0.26）的患者的身体成分综合评分显著更低。所有年龄组的女性和男性抑郁患者的精神成分综合评分均显著低于无抑郁者。
针对女性和男性的抑郁公共卫生干预和临床处理措施应针对男性的功能状况和女性的健康认知。
