Shen Guanghui, Chen Yu-Hsin, Zou Yang, Wu Shaochang, Zheng Yawen, Chen Li
Wenzhou Seventh People's Hospital, Wenzhou, 325006, China.
School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China.
BMC Public Health. 2025 Apr 17;25(1):1451. doi: 10.1186/s12889-025-22699-z.
Depression in middle-aged individuals is influenced by multiple factors; however, research focusing on this demographic remains limited. The social-ecological system framework explores how interactions among individual characteristics, social relationships, and environmental contexts contribute to health outcomes. This study aimed to assess the prevalence, core manifestations, and influencing factors of depression through a comprehensive model grounded in the social-ecological system.
Using data from the 2018 Chinese Labor Dynamic Survey, a total of 3,799 middle-aged individuals (mean age: 52.35 years; 53.75% female) were included. Depression was assessed using the Center for Epidemiological Studies Depression Scale, with a cut-off score of 36. We used a graphical gaussian model to identify the measurement network and core symptoms of midlife depression, and logistic regression to identify influencing factors. A social-ecological model of middle-aged depression was constructed through a Mixed Graphical Model.
23.74% of participants exhibited clinically significant depression. Feelings of disgust (Strength = 2.18, Expected Influence = 1.30) and incapacity (Strength = 1.29, Expected Influence = 1.57) emerged as the most central symptoms. Higher global strength (GS = 8.89, p < 0.001) of the network suggested stronger associations and mutual exacerbation of symptoms. Logistic regression showed that education, exercise, and subjective feeling were associated with depression risk (p < 0.05). The social-ecological system emphasized the importance of education (Strength = 2.50, Expected Influence = 2.50) and complex interaction between subjective and objective influencing factors.
This study found middle-aged individuals had a high prevalence of depression, characterized by feelings of disgust and incapacity. Influencing factors spanned individual, social and environmental levels. These results emphasize the role of education in depressive individuals, providing guidance for potential future interventions.
中年人群的抑郁症受多种因素影响；然而，针对这一人群的研究仍然有限。社会生态系统框架探讨了个体特征、社会关系和环境背景之间的相互作用如何影响健康结果。本研究旨在通过基于社会生态系统的综合模型评估抑郁症的患病率、核心表现及影响因素。
使用2018年中国劳动力动态调查的数据，共纳入3799名中年个体（平均年龄：52.35岁；53.75%为女性）。采用流行病学研究中心抑郁量表评估抑郁症，临界值为36分。我们使用图形高斯模型识别中年抑郁症的测量网络和核心症状，并使用逻辑回归识别影响因素。通过混合图形模型构建中年抑郁症的社会生态模型。
23.74%的参与者表现出具有临床意义的抑郁症。厌恶感（强度=2.18，预期影响=1.30）和无能感（强度=1.29，预期影响=1.57）是最核心的症状。网络的更高全局强度（GS=8.89，p<0.001）表明症状之间的关联更强且相互加剧。逻辑回归显示，教育程度、运动和主观感受与抑郁风险相关（p<0.05）。社会生态系统强调了教育的重要性（强度=2.50，预期影响=2.50）以及主观和客观影响因素之间的复杂相互作用。
本研究发现中年人群抑郁症患病率较高，以厌恶感和无能感为特征。影响因素涵盖个体、社会和环境层面。这些结果强调了教育在抑郁症患者中的作用，为未来潜在的干预措施提供了指导。
