显著的心境恶劣障碍：1990 年至 2019 年中国重性抑郁障碍和心境恶劣障碍的演变趋势，以及到 2030 年的预测。

Notable dysthymia: evolving trends of major depressive disorders and dysthymia in China from 1990 to 2019, and projections until 2030.

机构信息

Department of Psychology, Qilu Hospital of Shandong University, 107 Wenhuaxi Road, Jinan, Shandong, 250012, China.

Department of Neurology, The Second Hospital of Shandong University, Jinan, China.

出版信息

BMC Public Health. 2024 Jun 13;24(1):1585. doi: 10.1186/s12889-024-18943-7.

DOI:10.1186/s12889-024-18943-7

PMID:38872130

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11170895/

Abstract

BACKGROUND

Depressive disorders have been identified as a significant contributor to non-fatal health loss in China. Among the various subtypes of depressive disorders, dysthymia is gaining attention due to its similarity in clinical severity and disability to major depressive disorders (MDD). However, national epidemiological data on the burden of disease and risk factors of MDD and dysthymia in China are scarce.

METHODS

This study aimed to evaluate and compare the incidence, prevalence, and disability-adjusted life-years (DALYs) caused by MDD and dysthymia in China between 1990 and 2019. The temporal trends of the depressive disorder burden were evaluated using the average annual percentage change. The comparative risk assessment framework was used to estimate the proportion of DALYs attributed to risk factors, and a Bayesian age-period-cohort model was applied to project the burden of depressive disorders.

RESULTS

From 1990 to 2019, the overall age-standardized estimates of dysthymia in China remained stable, while MDD showed a decreasing trend. Since 2006, the raw prevalence of dysthymia exceeded that of MDD for the first time, and increased alternately with MDD in recent years. Moreover, while the prevalence and burden of MDD decreased in younger age groups, it increased in the aged population. In contrast, the prevalence and burden of dysthymia remained stable across different ages. In females, 11.34% of the DALYs attributable to depressive disorders in 2019 in China were caused by intimate partner violence, which has increasingly become prominent among older women. From 2020 to 2030, the age-standardized incidence, prevalence, and DALYs of dysthymia in China are projected to remain stable, while MDD is expected to continue declining.

CONCLUSIONS

To reduce the burden of depressive disorders in China, more attention and targeted strategies are needed for dysthymia. It's also urgent to control potential risk factors like intimate partner violence and develop intervention strategies for older women. These efforts are crucial for improving mental health outcomes in China.

摘要

背景

抑郁障碍已被确定为导致中国非致命性健康损失的重要因素。在各种抑郁障碍亚型中，心境恶劣障碍由于其在临床严重程度和残疾方面与重度抑郁障碍（MDD）相似，因此日益受到关注。然而，中国关于 MDD 和心境恶劣障碍的疾病负担和危险因素的全国性流行病学数据却很少。

方法

本研究旨在评估和比较 1990 年至 2019 年中国 MDD 和心境恶劣障碍的发病率、患病率和伤残调整生命年（DALYs）。使用平均年百分比变化来评估抑郁障碍负担的时间趋势。使用比较风险评估框架来估计归因于危险因素的 DALYs 比例，并应用贝叶斯年龄-时期-队列模型来预测抑郁障碍负担。

结果

从 1990 年到 2019 年，中国心境恶劣障碍的年龄标准化总体估计值保持稳定，而 MDD 呈下降趋势。自 2006 年以来，心境恶劣障碍的原始患病率首次超过 MDD，并在近年来与 MDD 交替增加。此外，虽然 MDD 在年轻人群中的患病率和负担呈下降趋势，但在老年人群中却呈上升趋势。相比之下，心境恶劣障碍的患病率和负担在不同年龄段保持稳定。在女性中，2019 年中国归因于抑郁障碍的 DALYs 中，11.34%是由亲密伴侣暴力引起的，这在老年女性中日益突出。从 2020 年到 2030 年，中国心境恶劣障碍的年龄标准化发病率、患病率和 DALYs 预计将保持稳定，而 MDD 预计将继续下降。