Geriatric Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
Community Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
BMJ Open. 2021 Dec 3;11(12):e048090. doi: 10.1136/bmjopen-2020-048090.
Previous studies on depression in rural areas have yielded conflicting results. Features of rural areas may be conducive or detrimental to mental health. Our objective for this study was to determine if there are rural-urban disparities in depressive symptoms between those living in rural and urban areas of Canada.
We conducted a cross-sectional analysis of a prospective cohort study, which is as representative as possible of the Canadian population-the Tracking Cohort of the Canadian Longitudinal Study on Aging. For this cohort, data were collected from 2010 to 2014. Data were analysed and results were obtained in 2020.
21 241 adults aged 45-85.
Rurality was grouped as urban (n=11 772); peri-urban (n=2637); mixed (n=2125; postal codes with both rural and urban areas); and rural (n=4707). Depressive symptoms were measured using the 10-item Center for Epidemiological Studies-Depression. We considered age, sex, education, marital status and disease states as potential confounding factors.
The adjusted beta coefficient was -0.24 (95% CI -0.42 to -0.07; p=0.01) for rural participants, -0.17 (95% CI -0.40 to 0.05; p=0.14) for peri-urban participants and -0.30 (95% CI -0.54 to -0.05; p=0.02) for participants in mixed regions, relative to urban regions. Risk factors associated with depressive symptoms were similar in rural and urban regions.
The small differences in depressive symptoms among those living in rural and urban regions are unlikely to be relevant at a clinical or population level. The findings do suggest some possible approaches to reducing depressive symptoms in both rural and urban populations. Future research is needed in other settings and on change in depressive symptoms over time.
先前关于农村地区抑郁症的研究结果相互矛盾。农村地区的特点可能对心理健康有益或有害。本研究的目的是确定在加拿大生活在农村和城市地区的人群中，抑郁症状是否存在城乡差异。
我们对一个前瞻性队列研究进行了横断面分析，该研究尽可能代表加拿大人群——加拿大老龄化纵向研究的跟踪队列。对于这个队列，数据是在 2010 年至 2014 年收集的。数据分析和结果是在 2020 年获得的。
21241 名年龄在 45-85 岁的成年人。
农村性被分为城市（n=11772）；城郊（n=2637）；混合（n=2125；邮政编码既有农村地区也有城市地区）；和农村（n=4707）。抑郁症状使用 10 项中心流行病学研究-抑郁量表来衡量。我们认为年龄、性别、教育、婚姻状况和疾病状态是潜在的混杂因素。
与城市地区相比，农村参与者的调整后β系数为-0.24（95%CI-0.42 至-0.07；p=0.01），城郊参与者为-0.17（95%CI-0.40 至 0.05；p=0.14），混合地区参与者为-0.30（95%CI-0.54 至-0.05；p=0.02）。与抑郁症状相关的风险因素在农村和城市地区相似。
生活在农村和城市地区的人群之间抑郁症状的微小差异在临床或人群层面上可能并不相关。这些发现确实表明了一些在农村和城市人口中减少抑郁症状的可能方法。需要在其他环境中进行进一步研究，并研究随着时间的推移抑郁症状的变化。
