Mahikul Wiriya, Lamlertthon Wisut, Ngaosuwan Kanchana, Nonthasaen Pawaree, Srisermphoak Napat, Chancharoen Wares, Chatree Saimai, Arnamwong Arpaporn, Narayam Pisinee, Wandeecharassri Chatchamon, Wongpanawiroj Pakin
Princess Srisavangavadhana College of Medicine, Chulabhorn Royal Academy, Bangkok, Thailand.
Chulabhorn Learning and Research Centre (CLRC), Chulabhorn Royal Academy, Bangkok, Thailand.
PLoS One. 2025 Jan 8;20(1):e0316077. doi: 10.1371/journal.pone.0316077. eCollection 2025.
Depression has a growing trend in the population worldwide. In this cross-sectional study, we investigated the prevalence and associated factors of depression among individuals residing in rural (Ban Luang district, Nan Province) and urban (Lak Si, Bangkok) areas of Thailand. Understanding the differences in depression between these two settings can provide insights for specific targeted interventions and mental health policies.
The multistage stratified random sampling was applied to select the study participants. We recruited participants from rural and urban communities in Thailand using a structured survey questionnaire through either face-to-face interviews or in paper or electronic form. We collected data on depression using the Patient Health Questionnaire-9 (PHQ-9) tool and sociodemographic characteristics and conducted descriptive statistics and logistic regression analysis.
Of 867 survey participants, 420 were from rural areas (Nan) and 447 were from urban areas (Bangkok). Participants' mean age was 55.9±9.5 years in rural areas and 56.0±12.0 years in urban areas. Most participants in urban areas were women, married, and had lower education levels (71.1%, 50.3%, 58.8%, respectively). The overall prevalence of depression across both settings was 18.6%. We found a higher prevalence of depression in the urban (31.8%) than the rural (4.5%) setting. In multiple logistic regression analysis, urban residence was significantly associated with higher rates of depression compared with rural residence (adjusted odds ratio [AOR] 9.43, 95% confidence interval [CI] 5.08-17.52). Nuclear family and using social media were associated with lower levels of depression in urban areas (AOR 0.50 and 0.43, 95% CI 0.27-0.93 and 0.22-0.84, respectively). Higher education level was significantly associated with higher levels of depression in rural areas (AOR 3.84, 95% CI 1.19-12.42).
This study emphasized the difference in depression and related factors between rural and urban areas of Thailand, highlighting a greater prevalence in urban areas. To help prevent depression, it is important to address specific challenges in each setting, such as those faced by highly educated individuals living in rural areas with high depression rates, exploring social media use patterns in urban populations, and understanding dynamics of the nuclear family. Our findings can inform the development of public health policies aimed at effectively mitigating the burden of depression and improving overall mental well-being in specific settings.
抑郁症在全球人口中的发病率呈上升趋势。在这项横断面研究中，我们调查了居住在泰国农村（南邦省班隆区）和城市（曼谷挽赐）地区的人群中抑郁症的患病率及相关因素。了解这两种环境下抑郁症的差异可为特定的针对性干预措施和心理健康政策提供见解。
采用多阶段分层随机抽样来选择研究参与者。我们通过结构化调查问卷，以面对面访谈或纸质或电子形式，从泰国农村和城市社区招募参与者。我们使用患者健康问卷-9（PHQ-9）工具收集抑郁症数据以及社会人口学特征数据，并进行描述性统计和逻辑回归分析。
在867名调查参与者中，420名来自农村地区（南邦），447名来自城市地区（曼谷）。农村地区参与者的平均年龄为55.9±9.5岁，城市地区为56.0±12.0岁。城市地区的大多数参与者为女性、已婚且教育水平较低（分别为71.1%、50.3%、58.8%）。两种环境下抑郁症的总体患病率为18.6%。我们发现城市地区抑郁症的患病率（31.8%）高于农村地区（4.5%）。在多因素逻辑回归分析中，与农村居住相比，城市居住与更高的抑郁症发病率显著相关（调整优势比[AOR]为9.43，95%置信区间[CI]为5.08 - 17.52）。核心家庭和使用社交媒体与城市地区较低的抑郁症水平相关（AOR分别为0.50和0.43，95%CI分别为0.27 - 0.93和0.22 - 0.84）。在农村地区，较高的教育水平与较高的抑郁症水平显著相关（AOR为3.84，95%CI为1.19 - 12.42）。
本研究强调了泰国农村和城市地区抑郁症及相关因素的差异，突出了城市地区患病率更高的情况。为帮助预防抑郁症，应对每种环境下的特定挑战很重要，比如居住在抑郁症发病率高的农村地区的高学历人群所面临的挑战、探索城市人群使用社交媒体的模式以及了解核心家庭的动态。我们的研究结果可为制定旨在有效减轻抑郁症负担并改善特定环境下总体心理健康状况的公共卫生政策提供参考。
