König Lars, Schröder Rebekka, Hamer Tim, Suhr Ralf
Stiftung Gesundheitswissen, Berlin, Germany.
Institut für Medizinische Soziologie und Rehabilitationswissenschaft, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Front Psychol. 2024 Dec 11;15:1494333. doi: 10.3389/fpsyg.2024.1494333. eCollection 2024.
Depressive disorders constitute a significant public health challenge. Health literacy might be an important factor to consider in prevention strategies for depressive disorders, which is why this study aimed at exploring the association between depressive symptom levels and severity and health literacy, along with additional sociodemographic factors.
Data were collected from two large samples of adults ( = 3,011) and adolescents ( = 1,021) representative of the German-speaking population in Germany. Levels of health literacy (HLS-EU-Q16 questionnaire), depressive symptom severity, rates of depression levels (PHQ-9 questionnaire) and sociodemographic information (age, gender, social status, level of education) were obtained. The associations between sociodemographic factors, health literacy and depression were analyzed using -tests, analyses of variance and χ-tests.
Overall, rates of depression were high in both samples (16.5% in adults and 18.4% in adolescents) when measured with the sum score ≥ 10 cut-off criterion and substantially lower when assessed with the diagnostic algorithm criterion (7.2% in adults and 9.8% in adolescents). Rates of depression and severity of depressive symptoms were higher in female than male individuals in both samples. Depressive symptom severity and depression rates increased with increasing age in adolescents and decreased with increasing age in adults. Higher levels of education and lower social status were associated with higher depressive symptom severity and rates in adults, with a more heterogeneous picture in adolescents. In both samples, depressive symptom severity and rates were higher in individuals with poorer health literacy.
The results point to a potential role for health literacy in preventing depressive disorders. More research is needed with longitudinal and experimental study designs into the question whether public health interventions targeting health literacy improvements could play a critical role in reducing the burden of depression across different age cohorts.
抑郁症构成了一项重大的公共卫生挑战。健康素养可能是抑郁症预防策略中需要考虑的一个重要因素，这就是本研究旨在探讨抑郁症状水平和严重程度与健康素养以及其他社会人口学因素之间关联的原因。
数据收集自德国说德语人群中具有代表性的两个大样本成年人（n = 3011）和青少年（n = 1021）。获取了健康素养水平（欧洲健康素养调查问卷 - HLS - EU - Q16）、抑郁症状严重程度、抑郁水平发生率（患者健康问卷 - 9 - PHQ - 9）以及社会人口学信息（年龄、性别、社会地位、教育程度）。使用t检验、方差分析和χ²检验分析社会人口学因素、健康素养与抑郁症之间的关联。
总体而言，当采用总分≥10的截断标准测量时，两个样本中的抑郁症发生率都很高（成年人中为16.5%，青少年中为18.4%），而使用诊断算法标准评估时则显著更低（成年人中为7.2%，青少年中为9.8%）。在两个样本中，女性的抑郁症发生率和抑郁症状严重程度均高于男性。在青少年中，抑郁症状严重程度和抑郁症发生率随年龄增长而增加，在成年人中则随年龄增长而降低。在成年人中，较高的教育水平和较低的社会地位与较高的抑郁症状严重程度和发生率相关，而在青少年中情况更为复杂。在两个样本中，健康素养较差的个体抑郁症状严重程度和发生率更高。
研究结果表明健康素养在预防抑郁症方面可能具有潜在作用。需要采用纵向和实验性研究设计进行更多研究，以探讨针对提高健康素养的公共卫生干预措施是否能在减轻不同年龄组抑郁症负担方面发挥关键作用。
