Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom; Department of Community Medicine, UiT, The Arctic University of Norway, Tromsø, Norway; National Heart and Lung Institute, Imperial College London, London, United Kingdom.
Institute of Philosophy and Law, Ural Branch of the Russian Academy of Sciences, Ekaterinburg, Russian Federation.
J Affect Disord. 2021 Jul 1;290:202-210. doi: 10.1016/j.jad.2021.04.093. Epub 2021 May 4.
Russia has a high burden of suicide and alcohol-attributable mortality. However there have been few studies of the epidemiology of depression.
The study population was 5077 men and women aged 35-69 years from a cross-sectional population based survey in the cities of Arkhangelsk and Novosibirsk (2015-17). Moderate depression was defined as Patient Health Questionnaire-9 (PHQ-9) score≥10. Risk factors considered were socio-demographic factors (age, sex, marital status, living alone, education, employment status, financial constraints); health behaviours (smoking, alcohol use) and psycho-social factors (life events and social support).
After mutual adjustment for all other factors, there was evidence that PHQ-9≥10 was associated with sex (higher in women), financial constraints, employment status, being a non-drinker, problem drinking, smoking, not having enough people to confide in and the number of life events in the past 6 months. Employment status was more strongly associated in men (OR 1.84 (95%CI 1.17, 2.88)) than women (OR 1.15 95% CI 0.86, 1.55). The effect size was particularly striking for financial constraints (odd ratio over 3 times higher in those with not enough money for food and clothes compared to no financial constraints), problem drinking (OR 1.72 (1.12, 2.65) among drinkers with CAGE score of 2 and 2.25 (95% CI 1.42, 3.57) in those with score ≥3 compared to zero) and life events (85% higher odds in those experiencing one life event and over 4 times higher odds in those experiencing 3 or more life events) all of which demonstrated a dose-response with PHQ-9>=10.
The study was cross-sectional in nature therefore temporal relationships could not be assessed.
We have identified here a range of risk factors for depression among the Russian general population consistent with findings from other populations. The strikingly strong association with financial constraints indicates the importance of social inequality for the burden of depression.
俄罗斯的自杀和酒精相关死亡率负担沉重。然而，关于抑郁症的流行病学研究却很少。
该研究人群为来自阿尔汉格尔斯克和新西伯利亚市的横断面人群调查中的 5077 名 35-69 岁的男性和女性（2015-17 年）。中度抑郁定义为患者健康问卷-9（PHQ-9）得分≥10。考虑的危险因素包括社会人口统计学因素（年龄、性别、婚姻状况、独居、教育、就业状况、经济拮据）；健康行为（吸烟、饮酒）和心理社会因素（生活事件和社会支持）。
在相互调整所有其他因素后，有证据表明 PHQ-9≥10 与性别（女性更高）、经济拮据、就业状况、不饮酒、饮酒问题、吸烟、无人倾诉以及过去 6 个月内的生活事件数量有关。与女性（OR 1.15 95%CI 0.86, 1.55）相比，男性的就业状况与 PHQ-9≥10 的相关性更强（OR 1.84（95%CI 1.17, 2.88））。经济拮据的影响特别显著（与没有足够的钱购买食物和衣服的人相比，那些经济拮据的人出现 PHQ-9 得分≥10 的比值高出 3 倍以上），在 CAGE 评分≥2 的饮酒者中，饮酒问题（OR 1.72（1.12, 2.65））和在 CAGE 评分≥3 的饮酒者中（OR 2.25（95%CI 1.42, 3.57））与无评分相比，生活事件（经历一次生活事件的几率高出 85%，经历 3 次或更多生活事件的几率高出 4 倍以上）都与 PHQ-9≥10 呈剂量反应关系。
该研究本质上是横断面研究，因此无法评估时间关系。
我们在这里确定了一系列与俄罗斯普通人群中抑郁症相关的危险因素，与其他人群的研究结果一致。与经济拮据的关系非常密切，表明社会不平等对抑郁症负担的重要性。
