Department of Epidemiology and Biostatistics, School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China.
Suzhou Centers for Disease Control and Prevention, Suzhou, China.
J Psychiatr Res. 2024 May;173:340-346. doi: 10.1016/j.jpsychires.2024.03.032. Epub 2024 Mar 23.
Depressive symptoms are highly prevalent and increase risks of various morbidities. However, the extent to which depressive symptoms could account for incidence of these chronic conditions, in particular multimorbidity patterns, remains to be examined and quantified.
For this cohort analysis, we included 9024-14,093 participants aged 45 years and older from the China Health and Retirement Longitudinal Study (CHARLS). Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the longitudinal associations between depressive symptoms and 13 common chronic diseases and 4 multimorbidity patterns. Population attributable fractions (PAFs) combining the information on both exposure prevalence and risk association were estimated to quantify the magnitude of the burden of these conditions attributable to depressive symptoms.
Depressive symptoms were associated with increased risks of liver disease, stroke, heart problem, asthma, diabetes, arthritis, kidney disease, chronic lung disease, digestive disease, dyslipidemia, and memory-related disease, and the adjusted HRs (95% CIs) and PAFs (95% CIs) ranged from 1.15 (1.05-1.26) to 1.64 (1.38-1.96) and 5% (0-10%) to 17% (6-28%), respectively. In addition, individuals with depressive symptoms had elevated risks of the cardiometabolic-cancer pattern, the cerebrovascular-memory pattern, the articular-visceral organ pattern, and the respiratory pattern, with respective HRs (95% CIs) of 1.26 (1.11-1.42), 1.34 (1.07-1.69), 1.45 (1.29-1.63), and 2.01 (1.36-2.96), and respective PAFs (95% CIs) of 5% (0-10%), 8% (-4-21%), 12% (7-17%), and 20% (5-35%).
Depressive symptoms contribute substantially to the burden across a broad range of chronic diseases as well as different multimorbidity patterns in middle-aged and older Chinese.
抑郁症状普遍存在，并增加了各种病态的风险。然而，抑郁症状在多大程度上可以解释这些慢性疾病的发生，特别是多种疾病模式，仍有待检验和量化。
在这项队列分析中，我们纳入了中国健康与退休纵向研究（CHARLS）中 9024-14093 名 45 岁及以上的参与者。使用 Cox 比例风险模型来估计抑郁症状与 13 种常见慢性疾病和 4 种多种疾病模式之间的纵向关联的风险比（HRs）和 95%置信区间（CIs）。结合暴露流行率和风险关联信息来估计人群归因分数（PAFs），以量化这些疾病归因于抑郁症状的负担的大小。
抑郁症状与肝病、中风、心脏问题、哮喘、糖尿病、关节炎、肾脏疾病、慢性肺病、消化系统疾病、血脂异常和记忆相关疾病的风险增加相关，调整后的 HRs（95% CIs）和 PAFs（95% CIs）范围为 1.15（1.05-1.26）至 1.64（1.38-1.96）和 5%（0-10%）至 17%（6-28%）。此外，患有抑郁症状的个体发生心血管代谢-癌症模式、脑血管-记忆模式、关节-内脏器官模式和呼吸系统模式的风险增加，相应的 HRs（95% CIs）分别为 1.26（1.11-1.42）、1.34（1.07-1.69）、1.45（1.29-1.63）和 2.01（1.36-2.96），相应的 PAFs（95% CIs）分别为 5%（0-10%）、8%（-4-21%）、12%（7-17%）和 20%（5-35%）。
抑郁症状在中国中年及以上人群中，对广泛的慢性疾病以及不同的多种疾病模式造成了相当大的负担。
