Yu Lingling, Chen Chuqian
Department of Philosophy and Science, Southeast University at Nanjing, Nanjing, China.
Department of Medical Humanities, Southeast University at Nanjing, Nanjing, China.
Psych J. 2024 Jun;13(3):494-511. doi: 10.1002/pchj.729. Epub 2024 Jan 24.
Comorbid depression and anxiety causes serious psychological and physiological damage for older people. This study aimed to identify heterogeneous classes of comorbid depression and anxiety (CDA) among older people in China and to ascertain predictors of latent class membership. Cross-sectional data of 10,919 cases were extracted from the Chinese Longitudinal Healthy Longevity Survey. Latent profile analysis (LPA) was used to identify symptom patterns of comorbid depression (measured by the 10-item Center for Epidemiologic Studies Depression Scale) and anxiety (measured by the Generalized Anxiety Disorder 7-item Scale). Multinomial logistic regressions following bivariate analyses were used to explore the relationship between the derived classes and individual- and social-level factors. Four patterns of CDA were identified: low symptoms of depression and anxiety (30.52%; n = 3333), mild depression only (53.26%; n = 5815), moderate depression and anxiety (13.82%; n = 1509), and severe depression and anxiety (2.40%; n = 262). Older people who are male, suffer from multimorbidity, and lack a healthy lifestyle are more likely to have problematic symptom profiles. While intimate relationships with partners and children significantly predicted CDA patterns, the effects of sibling relationships, daily life, and emotional support from the community were insignificant. LPA identified four distinct CDA patterns among a representative sample of older Chinese people. While restless sleep, lack of positive emotions, uselessness, and weak concentration are salient across all profiles, "difficult to relax" is prominent in profiles high in anxiety. In addition to individual-level variables, social-level factors, especially intimate relationships with partners and children rather than general links to siblings or the community, have unneglectable impacts on whether and to what extent older Chinese adults suffer from CDA in the cultural context of relationism, patriarchy, and filial piety.
共病抑郁和焦虑会给老年人造成严重的心理和生理损害。本研究旨在识别中国老年人中共病抑郁和焦虑（CDA）的不同类别，并确定潜在类别成员的预测因素。从中国老年健康长寿纵向调查中提取了10919例的横断面数据。采用潜在剖面分析（LPA）来识别共病抑郁（通过10项流行病学研究中心抑郁量表测量）和焦虑（通过广泛性焦虑障碍7项量表测量）的症状模式。双变量分析后的多项逻辑回归用于探讨派生类别与个人和社会层面因素之间的关系。识别出四种CDA模式：抑郁和焦虑症状较轻（30.52%；n = 3333）、仅轻度抑郁（53.26%；n = 5815）、中度抑郁和焦虑（13.82%；n = 1509）以及重度抑郁和焦虑（2.40%；n = 262）。男性、患有多种疾病且缺乏健康生活方式的老年人更有可能出现有问题的症状特征。虽然与伴侣和子女的亲密关系显著预测了CDA模式，但兄弟姐妹关系、日常生活和社区情感支持的影响并不显著。LPA在中国老年人的代表性样本中识别出四种不同的CDA模式。虽然睡眠不安、缺乏积极情绪、无用感和注意力不集中在所有特征中都很突出，但“难以放松”在焦虑程度较高的特征中尤为明显。除了个人层面的变量外，社会层面的因素，尤其是与伴侣和子女而非与兄弟姐妹或社区的一般联系，在关系主义、父权制和孝道的文化背景下，对中国老年人是否以及在多大程度上患有CDA具有不可忽视的影响。
