Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
Graduate School of Public Health and Healthcare Management, The Catholic University of Korea, Republic of Korea.
Int J Soc Psychiatry. 2023 Nov;69(7):1670-1681. doi: 10.1177/00207640231174363. Epub 2023 May 25.
Evidence suggests that people with disabilities are more likely to suffer from depression. Previous studies have focused on depressive disorders in specific disability types or age groups using small-scale cross-sectional samples. We investigated longitudinal trends in the prevalence and incidence of depressive disorders according to disability types and severity levels in the entire Korean adult population.
The age-standardised prevalence and incidence of depressive disorders were investigated using National Health Insurance claims data from 2006 to 2017. The odds of depressive disorders by type and severity were examined using logistic regression after adjusting for sociodemographic characteristics and comorbidities based on merged 2006 to 2017 data.
Both the incidence and prevalence of depressive disorders were higher among the disabled than the non-disabled, with the prevalence gap being larger than the incidence gap. In regression analyses, adjusting for sociodemographic characteristics and comorbidities considerably reduced the odds ratios, particularly for incidence. The severity of disabilities was inversely associated with the incidence of depressive disorders. Brain injury and disabilities in major internal organs were associated with lower odds of developing depressive disorders than in non-disabled individuals.
A significant proportion of depressive disorders in disabled individuals are caused by financial hardships or comorbidities rather than disabilities themselves. We must pay special attention to those who cannot access healthcare services due to severe disabilities and those whose depressive disorders are misdiagnosed as intellectual disabilities. More research is required to elucidate the causal mechanisms underlying depressive disorders in people with various types and severities of disabilities.
有证据表明，残疾人更容易患抑郁症。以往的研究主要集中在特定残疾类型或年龄组的抑郁障碍上，使用的是小规模的横断面样本。我们调查了全韩国成年人群体中根据残疾类型和严重程度的抑郁障碍的患病率和发生率的纵向趋势。
使用 2006 年至 2017 年国家健康保险索赔数据调查了年龄标准化的抑郁障碍患病率和发生率。使用基于合并 2006 年至 2017 年的数据的逻辑回归，在调整了社会人口统计学特征和合并症后，检查了不同残疾类型和严重程度的抑郁障碍的可能性。
与非残疾者相比，残疾者的抑郁障碍发生率和患病率均较高，且患病率差距大于发病率差距。在回归分析中，调整社会人口统计学特征和合并症后，比值比明显降低，尤其是对发病率而言。残疾的严重程度与抑郁障碍的发生率呈负相关。脑损伤和主要内部器官残疾与非残疾个体相比，发展抑郁障碍的几率较低。
残疾者中相当一部分抑郁障碍是由经济困难或合并症引起的，而不是残疾本身。我们必须特别关注那些因严重残疾而无法获得医疗服务的人，以及那些被误诊为智力残疾的人。需要进一步研究以阐明各种类型和严重程度的残疾者中抑郁障碍的因果机制。
