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预测老年抑郁症的社会和心理社会因素:一项纵向研究。

Social and psychosocial factors predicting depression in old age: a longitudinal study.

作者信息

Kivelä S L, Köngäs-Saviaro P, Laippala P, Pahkala K, Kesti E

机构信息

University of Oulu, Department of Public Health Science and General Practice, Oulu, Finland.

出版信息

Int Psychogeriatr. 1996 Winter;8(4):635-44. doi: 10.1017/s1041610296002943.

Abstract

The predictive value of social and psychosocial factors for the occurrence of depression in elderly Finns is described using a longitudinal design. A population determined as not being depressed in an epidemiological study in 1984-1985 was clinically interviewed and examined in a follow-up study in 1989-1990 (N = 679). The potential predictive factors for depression were analyzed by contrasting the persons depressed in 1989-1990 with the ones not depressed. In men, depression was predicted by a poor relationship with one's wife and feelings about low appreciation of old persons or of the participant himself during the initial study and the loss of a mother while under 20 years of age. Certain changes and life events during the follow-up were related to the occurrence of depression in men, such as a change in the relationship with one's wife into a poorer direction, a decrease in the amount of hobbies, getting married, a grandchild's divorce, separation from someone important, moving into long-term institutional care, giving up hobbies or a position in a voluntary organization, and alcohol problems of a close person. In women, depression was predicted by living together with one's husband, living with other people, and a low activity in participating in religious events during the initial study and a loss of father while under 20 years of age. The risk of women living alone was lower compared to women not living alone. Also, certain changes and life events during the follow-up were associated with a high risk of depression in women, including a change in the relationship with one's neighbors into a poorer direction, an increase in the amount of time spent alone, a decline of the social activity level, getting married, occurrence of serious marital problems, separation from someone important, giving up hobbies or a position in a voluntary organization, alcohol problems of a close person, and a small number of social growth events. The results support the hypothesis about psychosocial factors playing a role in the etiology of depression in old age.

摘要

采用纵向研究设计描述了社会和心理社会因素对芬兰老年人抑郁症发生的预测价值。在1984 - 1985年的一项流行病学研究中被确定为未患抑郁症的人群,在1989 - 1990年的随访研究中接受了临床访谈和检查(N = 679)。通过对比1989 - 1990年患抑郁症的人和未患抑郁症的人,分析了抑郁症的潜在预测因素。在男性中,抑郁症的预测因素包括在初始研究期间与妻子关系不佳、对老年人或参与者自身评价较低的感受以及20岁之前母亲去世。随访期间的某些变化和生活事件与男性抑郁症的发生有关,例如与妻子关系向更差方向转变、爱好数量减少、结婚、孙子离婚、与重要人物分离、进入长期机构护理、放弃爱好或在志愿组织中的职位以及亲密的人存在酒精问题。在女性中,抑郁症的预测因素包括在初始研究期间与丈夫同住、与他人同住、参与宗教活动的活跃度较低以及20岁之前父亲去世。与非独居女性相比,独居女性患抑郁症的风险较低。此外,随访期间的某些变化和生活事件与女性患抑郁症的高风险相关,包括与邻居关系向更差方向转变、独自度过的时间增加、社交活动水平下降、结婚、出现严重婚姻问题、与重要人物分离、放弃爱好或在志愿组织中的职位、亲密的人存在酒精问题以及社交成长事件数量较少。研究结果支持了心理社会因素在老年抑郁症病因中起作用的假设。

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