School of Education Science and Technology, Guangdong Polytechnic Normal University, Guangzhou, China.
School of Information Technology Education, South China Normal University, Guangzhou, China.
J Affect Disord. 2022 Mar 15;301:360-367. doi: 10.1016/j.jad.2022.01.010. Epub 2022 Jan 4.
Our study investigated the relationships between the prevalence of depressive symptoms and education levels in those aged ≥20 years.
A total of 34,102 participants from the National Health and Nutrition Examination Surveys 2005-2018 were involved in our cross-sectional study. The relations of depressive symptoms (as outcome variable) and education levels (as an independent variable) were analyzed using multivariable logistic regression models in the main analyzes. Sensitivity analyzes, including a multiple sensitivity analysis, were also performed.
The education levels were negatively associated with depressive symptoms after adjusting related covariates. Compared with the reference group of individuals with less than 9th grade, people with college graduate or above had an adjusted odds ratio (OR) of 0.464 (95% CI 0.361, 0.595, P < 0.0001). On the other hand, the statistically significant negative association disappeared among Mexican Americans, other races, separated, and high family poverty income ratio group. These results remained stable under a wide range of sensitivity analyzes.
Our study indicated the elevated education levels correlated with the decreased prevalence of depressive symptoms, and race, marital status, and family economic factors played a critical role in the relationship. This report reminds us to pay close attention to the further study of factors that affected the association between depressive symptoms and education levels.
The cross-sectional study leaves problems about the direction of causality unclear.
本研究调查了 20 岁及以上人群中抑郁症状的流行率与教育水平之间的关系。
我们的横断面研究共纳入了来自 2005-2018 年国家健康和营养调查的 34102 名参与者。使用多变量逻辑回归模型对抑郁症状（作为因变量）和教育水平（作为自变量）之间的关系进行了主要分析。还进行了敏感性分析，包括多次敏感性分析。
在校正了相关协变量后，教育水平与抑郁症状呈负相关。与 9 年级以下的参考组相比，具有大学毕业或以上学历的人群的调整后比值比（OR）为 0.464（95%CI 0.361，0.595，P<0.0001）。另一方面，在墨西哥裔美国人、其他种族、离异和高家庭贫困收入比组中，这种统计学上显著的负相关关系消失了。在广泛的敏感性分析下，这些结果仍然稳定。
我们的研究表明，较高的教育水平与抑郁症状的患病率降低相关，种族、婚姻状况和家庭经济因素在这种关系中起着关键作用。该报告提醒我们密切关注影响抑郁症状和教育水平之间关联的因素的进一步研究。
横断面研究使得因果关系的方向问题不明确。
