Ji Yanhu, Chen Changhao, Xu Guangxing, Song Jian, Su Hong, Wang Heng
Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China.
Department of Psychiatry, Suzhou Second People's Hospital, Suzhou, China.
Environ Sci Pollut Res Int. 2023 Jan;30(1):2075-2085. doi: 10.1007/s11356-022-22390-5. Epub 2022 Aug 4.
Previous epidemiological studies have reported seasonal variation patterns of depression symptoms, which may be influenced by bad weather conditions, such as a lack of sunlight. However, evidence on the acute effects of sunshine duration on outpatient visits for depression is limited, especially in developing countries, and the results are inconsistent. We collected daily outpatient visits for depression from the local mental health centre in Suzhou, Anhui Province, China, during 2017-2019. We defined the 5th and 95th sunshine percentiles as short and long sunshine durations, respectively. A quasi-Poisson generalized linear regression model combined with a distributed lag nonlinear model was used to quantitatively assess the effects of short and long sunshine durations on outpatient visits for depression. Stratified analyses were further performed by gender, age and number of visits to identify vulnerable populations. A total of 26,343 depression cases were collected during the study period. An approximate U-shaped exposure-response association was observed between sunshine duration and depression outpatient visits. The cumulative estimated relative risks (RRs) for short and long sunshine durations at lag 0-21 days were 1.53 [95% confidence intervals (CI): 1.14, 2.06] and 1.13 (95% CI: 0.88, 1.44), respectively. Moreover, a short sunshine duration was associated with a greater disease burden than a long sunshine duration, with attributable fractions (AFs) of 16.64% (95% CI: 7.8%, 23.89%) and 2.24% (95% CI: -2.65%, 5.74%), respectively. Subgroup analysis showed that males, people aged less than 45 years and first-visit cases may be more susceptible to a lack of sunlight. For a long sunshine duration, no statistically significant associations were found in any population groups. Our study found that a short sunshine duration was associated with an increased risk of depression. The government, medical institutions, family members and patients themselves should fully recognize the important role of sunlight and take active measures to prevent depression.
以往的流行病学研究报告了抑郁症状的季节性变化模式，这可能受到恶劣天气条件的影响，如缺乏阳光。然而，关于日照时长对抑郁症门诊就诊的急性影响的证据有限，尤其是在发展中国家，且结果并不一致。我们收集了2017 - 2019年期间中国安徽省苏州市当地心理健康中心的每日抑郁症门诊就诊数据。我们将日照百分位数的第5位和第95位分别定义为短日照时长和长日照时长。采用准泊松广义线性回归模型结合分布滞后非线性模型，定量评估短日照时长和长日照时长对抑郁症门诊就诊的影响。进一步按性别、年龄和就诊次数进行分层分析，以确定易感人群。研究期间共收集到26343例抑郁症病例。日照时长与抑郁症门诊就诊之间观察到近似U型的暴露 - 反应关联。在滞后0 - 21天，短日照时长和长日照时长的累积估计相对风险（RRs）分别为1.53 [95%置信区间（CI）：1.14, 2.06]和1.13（95% CI：0.88, 1.44）。此外，短日照时长比长日照时长与更高的疾病负担相关，归因分数（AFs）分别为16.64%（95% CI：7.8%, 23.89%）和2.24%（95% CI： - 2.65%, 5.74%）。亚组分析表明，男性、年龄小于45岁的人群和初诊病例可能更容易受到阳光缺乏的影响。对于长日照时长，在任何人群组中均未发现具有统计学意义的关联。我们的研究发现，短日照时长与抑郁症风险增加相关。政府、医疗机构、家庭成员和患者自身应充分认识阳光的重要作用，并采取积极措施预防抑郁症。
