基于倾向评分匹配法的大型多中心横断面研究：探讨住院医师中重度抑郁症和自杀意念的患病率及相关因素。
The prevalence and risk factors for major depression and suicidal ideation in medical residents based on a large multi-center cross-sectional study using the propensity score-matched method.
机构信息
Department of Urology, Shengjing Hospital of China Medical University, No. 36, San Hao Street, Shenyang, 110004, Liaoning, China.
Department of Graduate Medical Education, Health Service Center of Liaoning Province, Shenyang, China.
出版信息
Soc Psychiatry Psychiatr Epidemiol. 2022 Nov;57(11):2279-2291. doi: 10.1007/s00127-022-02351-6. Epub 2022 Aug 27.
INTRODUCTION
We determined the prevalence of major depression and suicidal ideation, and the associated risk factors in a large sample of Chinese resident physicians.
METHODS
This multi-center cross-sectional study was conducted from December 2019 to February 2020 and involved 1343 residents from eight centers. Extensive characteristics, including demographics, dietary habits, life-related factors, work-related factors, and psychological factors were collected based on a self-reported questionnaire. Specific scales measured the levels of sleep quality, physical activity, depression, perceived organization support, psychological capital, and burnout. Adjusted odds ratios and 95% confidence intervals were determined by binary paired logistic regression.
RESULTS
Of the residents enrolled in the study, 12.90% suffered from major depression and 9.70% suffered from suicidal ideation. Four overlapped independent risk factors were identified for major depression and suicidal ideation: poor sleep quality (OR = 1.317, OR = 1.200); lower optimism of psychological capital (OR = 0.899, OR = 0.835); higher depersonalization, (OR = 1.086, OR = 1.097); and reduced personal accomplishment (OR = 0.963, OR = 0.962). The inappropriate working duration weekly (< 40 h vs. 40-60 h; OR = 2.812, > 60 h vs. 40-60 h; OR = 1.945), and higher emotional exhaustion (OR = 1.121) were the only risk factors for major depression. Higher hope of psychological capital (OR = 1.077) was only for suicidal ideation.
CONCLUSION
This study revealed a substantial prevalence of major depression and suicidal ideation in Chinese residents, and identified several shared risk factors for major depression and suicidal ideation. These findings enrich the existing theoretical model of depression and demonstrated a critical need for additional studies that investigate intervention strategies that can address the mental health in residents.
TRIAL REGISTRATION
Chinese Clinical Trial Registry, ChiCTR1900027707. Registered 24 Nov. 2019, http://www.chictr.org.cn/index.aspx.
简介
我们在大量中国住院医师样本中确定了重度抑郁症和自杀意念的患病率及其相关危险因素。
方法
本多中心横断面研究于 2019 年 12 月至 2020 年 2 月进行，涉及 8 个中心的 1343 名住院医师。根据自我报告问卷收集了广泛的特征，包括人口统计学、饮食习惯、生活相关因素、工作相关因素和心理因素。特定量表测量了睡眠质量、身体活动、抑郁、感知组织支持、心理资本和倦怠水平。通过二项配对逻辑回归确定调整后的优势比和 95%置信区间。
结果
在所纳入的住院医师中，12.90%患有重度抑郁症，9.70%患有自杀意念。确定了 4 个重叠的独立危险因素：睡眠质量差（OR=1.317，OR=1.200）；心理资本乐观程度较低（OR=0.899，OR=0.835）；去人格化程度较高（OR=1.086，OR=1.097）；个人成就感降低（OR=0.963，OR=0.962）。每周工作时间不当（<40 h 与 40-60 h 相比；OR=2.812，>60 h 与 40-60 h 相比；OR=1.945）和较高的情绪耗竭（OR=1.121）是重度抑郁症的唯一危险因素。较高的心理资本希望（OR=1.077）仅与自杀意念相关。
结论
本研究揭示了中国住院医师中重度抑郁症和自杀意念的患病率较高，并确定了几个与重度抑郁症和自杀意念相关的共同危险因素。这些发现丰富了现有的抑郁理论模型，并表明需要进一步研究以探索可以解决居民心理健康问题的干预策略。
试验注册
中国临床试验注册中心，ChiCTR1900027707。注册于 2019 年 11 月 24 日，http://www.chictr.org.cn/index.aspx。
Zotero 插件