Mulsant B H, Ganguli M, Seaberg E C
Department of Psychiatry, University of Pittsburgh School of Medicine, Pennsylvania, USA.
J Am Geriatr Soc. 1997 Aug;45(8):954-8. doi: 10.1111/j.1532-5415.1997.tb02966.x.
To confirm the association between depression and self-rated general health, independent of demographics, functional disability, physical illness burden, and health services utilization.
Logistic regression analyses of data obtained in a cross-sectional epidemiological survey.
The mid-Monongahela Valley, a rural, nonfarm, low SES community.
Random sample of 880 subjects aged 65 and older.
The dependent variable was self-rated overall health, categorized as excellent, good, fair, or poor. The independent variables were demographics (age, gender, education), number of depressive symptoms, number of impaired instrumental activities of daily living (IADLs), measures of physical illness burden (individual medical conditions, number of affected organ systems or disease processes, and number of prescription medications), and measures of health services utilization (number of visits to physicians, and acute hospitalization).
Univariate analyses indicated that poorer self-rated health was associated with lesser education, higher numbers of depressive symptoms, impaired IADLs, prescription medications, physician visits, hospitalizations, and affected organ systems, and with the presence of several specific conditions. However, multiple logistic regression analyses revealed that only the following variables were associated independently with poorer self-rated health: age less than 75 years, education less than high school graduation, greater numbers of depressive symptoms, impaired IADLs, prescription medications, and physician visits.
Even when controlling for physical illness and functional disability, subjective rating of overall health remains strongly and independently associated with depressive symptoms.
确认抑郁症与自评总体健康之间的关联，该关联独立于人口统计学因素、功能残疾、身体疾病负担和医疗服务利用情况。
对横断面流行病学调查所获数据进行逻辑回归分析。
莫农加希拉河谷中部，一个农村、非农业、社会经济地位较低的社区。
880名65岁及以上受试者的随机样本。
因变量为自评总体健康状况，分为优秀、良好、中等或差。自变量包括人口统计学因素（年龄、性别、教育程度）、抑郁症状数量、日常生活工具性活动受损数量、身体疾病负担指标（个体医疗状况、受影响的器官系统或疾病过程数量以及处方药数量）以及医疗服务利用指标（就诊次数和急性住院情况）。
单因素分析表明，自评健康状况较差与教育程度较低、抑郁症状数量较多、日常生活工具性活动受损、使用处方药、就诊、住院以及受影响的器官系统数量较多以及存在几种特定疾病有关。然而，多因素逻辑回归分析显示，只有以下变量与自评健康状况较差独立相关：年龄小于75岁、教育程度低于高中毕业、抑郁症状数量较多、日常生活工具性活动受损、使用处方药和就诊。
即使控制了身体疾病和功能残疾因素，总体健康的主观评分仍与抑郁症状密切且独立相关。
