童年期发病与成年期发病的残疾成年人中抑郁和焦虑症状的发生率

Frequency of depression and anxiety symptoms among adults with childhood- versus adult-onset disability.

作者信息

Sarmiento Cristina A, Furniss Anna, Morris Megan A, Stransky Michelle L, Thompson Darcy A

机构信息

Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.

Division of Pediatric Rehabilitation Medicine, Children's Hospital Colorado, Aurora, Colorado, USA.

出版信息

PM R. 2025 Apr;17(4):408-418. doi: 10.1002/pmrj.13333. Epub 2025 Feb 5.

DOI:10.1002/pmrj.13333

PMID:39907356

Abstract

BACKGROUND

Individuals with disabilities experience high rates of depression and anxiety. Potential differences between those with childhood- versus adult-onset disability have not been adequately explored.

OBJECTIVE

To examine the relationship between age of disability onset and frequency of reported depression and anxiety symptoms.

DESIGN

Secondary data analysis.

SETTING

2020-2021 National Health Interview Survey (NHIS), a nationally representative survey of adults on illness and disability in the United States.

PARTICIPANTS

NHIS respondents aged 22-80 years with mobility, cognitive, or mobility + cognitive disability (n = 6386).

INTERVENTIONS

Age of disability onset (childhood onset, defined as onset before age 22, per NHIS question, vs. adult onset) was our independent variable.

MAIN OUTCOME MEASURES

We calculated frequency of reported current depression and anxiety symptoms among those with childhood- versus adult-onset disability. Logistic regression was used to calculate the odds ratios (OR) of frequent versus infrequent depression and anxiety symptoms for childhood- versus adult-onset disability, adjusted for demographic factors.

RESULTS

A higher percentage of participants with childhood- compared to adult-onset disability reported frequent depression symptoms (mobility: 32.7% vs. 21.9%, p < .01; cognitive: 55.6% vs. 44.5%, p < .01; mobility + cognitive: 71.4% vs. 52.8%, p < .01) and anxiety symptoms (mobility: 44.3% vs. 35.5%, p < .01; cognitive: 83.5% vs. 63.1%, p < .01; mobility + cognitive: 82.8% vs. 70.3%, p < .01). Participants with childhood-onset disability had higher adjusted odds of frequent depression symptoms for all disability types (mobility adjusted odds ratio [aOR], 1.58 [95% confidence interval (CI), 1.15-2.16]; cognitive aOR, 1.84 [95% CI, 1.12-3.02]; mobility + cognitive aOR, 2.06 [95% CI, 1.16-3.67]), and frequent anxiety symptoms for cognitive (aOR, 3.28 [95% CI, 1.92-5.60]) and mobility + cognitive disabilities (aOR, 2.01 [95% CI, 1.07-3.75]) compared to those with adult-onset disability.

CONCLUSION

Individuals with childhood-onset disabilities may be at uniquely higher risk for mental health symptoms than their peers with adult-onset disabilities, warranting specific attention to their health care and outcomes.

摘要

背景

残疾个体患抑郁症和焦虑症的比例较高。儿童期发病与成年期发病的残疾个体之间的潜在差异尚未得到充分研究。

目的

探讨残疾发病年龄与报告的抑郁和焦虑症状频率之间的关系。

设计

二次数据分析。

背景

2020 - 2021年美国国家健康访谈调查（NHIS），这是一项针对美国成年人疾病和残疾情况的全国代表性调查。

参与者

年龄在22 - 80岁之间、患有行动障碍、认知障碍或行动 + 认知障碍的NHIS受访者（n = 6386）。

干预措施

我们的自变量是残疾发病年龄（儿童期发病，根据NHIS问题定义为22岁之前发病，与成年期发病相对）。

主要结局指标

我们计算了儿童期发病与成年期发病的残疾个体中报告的当前抑郁和焦虑症状的频率。采用逻辑回归计算儿童期发病与成年期发病的残疾个体出现频繁与不频繁抑郁和焦虑症状的比值比（OR），并对人口统计学因素进行了调整。

结果

与成年期发病的残疾个体相比，儿童期发病的残疾个体中报告频繁抑郁症状的比例更高（行动障碍：32.7%对21.9%，p < 0.01；认知障碍：55.6%对44.5%，p < 0.01；行动 + 认知障碍：71.4%对52.8%，p < 0.01）以及焦虑症状（行动障碍：44.3%对35.5%，p < 0.01；认知障碍：83.5%对63.1%，p < 0.01；行动 + 认知障碍：82.8%对70.3%，p < 0.01）。对于所有残疾类型，儿童期发病的残疾个体出现频繁抑郁症状的调整后比值比更高（行动障碍调整后比值比[aOR]，1.58 [95%置信区间（CI），1.15 - 2.16]；认知障碍aOR，1.84 [95% CI，1.12 - 3.02]；行动 + 认知障碍aOR，2.06 [95% CI，1.16 - 3.67]），与成年期发病的残疾个体相比，认知障碍（aOR，3.28 [95% CI，1.92 - 5.60]）和行动 + 认知障碍（aOR，2.01 [95% CI，1.07 - 3.75]）出现频繁焦虑症状的情况也是如此。