Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan 410078, China.
Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan 410078, China.
Psychiatry Res. 2023 Nov;329:115548. doi: 10.1016/j.psychres.2023.115548. Epub 2023 Oct 16.
The role of social determinants of health (SDoH) in gender differences in depression remains unclear among Chinese adults. We aimed to explore the association between SDoH and depression and investigate their role in explaining gender differences in depression. This prospective longitudinal cohort study used four wave surveys (2012, 2016, 2018, and 2020) of the China Family Panel Study (CFPS). Fourteen SDoH variables were assessed, and depression was measured using the 8-item short version of the Center for Epidemiologic Studies Depression Scale. The Cox proportional hazards regression and multiple mediation analysis were performed to estimate the effect sizes. The longitudinal sample included 18,874 participants aged 18-92 years (51.4 % males and 48.6 % females). Women had higher risk of depression than men. Unfavorable SDoH were associated with higher risk of depression. After including multiple SDoH in mediation analysis, multiple SDoH mediated 15.7 % of the total effect of gender on depression. In sum, SDoH significantly influenced depression, and specific factors explained gender differences in depression. Supporting women in education, employment, and community involvement could help reduce gender differences in depression.
社会决定因素（SDoH）在抑郁症中的性别差异在成年中国人中仍不清楚。我们旨在探讨 SDoH 与抑郁症之间的关联，并研究它们在解释抑郁症性别差异中的作用。本前瞻性纵向队列研究使用了中国家庭追踪调查（CFPS）的四个波次调查（2012 年、2016 年、2018 年和 2020 年）。评估了 14 个 SDoH 变量，使用流行病学研究中心抑郁量表的 8 项简短版本来衡量抑郁情况。采用 Cox 比例风险回归和多重中介分析来估计效应大小。纵向样本包括 18874 名年龄在 18-92 岁的参与者（男性占 51.4%，女性占 48.6%）。女性患抑郁症的风险高于男性。不良的 SDoH 与更高的抑郁症风险相关。在中介分析中纳入多个 SDoH 后，多个 SDoH 解释了性别对抑郁症总效应的 15.7%。总之，SDoH 显著影响了抑郁症，特定因素解释了抑郁症的性别差异。支持女性在教育、就业和社区参与方面的发展可以帮助减少抑郁症的性别差异。
