老年人抑郁症状合并躯体疼痛的相关因素

目的:探讨我国老年人抑郁症状合并躯体疼痛的患病情况及相关因素,为改善伴抑郁症状合并躯体疼痛老年人生活质量提供参考依据。方法:基于中国健康与养老追踪调查(China Health and Retirement Longitudinal Study,CHARLS)的数据,选取其中所有有抑郁症状[简版流调中心抑郁量表(CESD-10)得分10分]的老年人(年龄≥60岁)2370例,其中有1335例合并躯体疼痛(DP组,主诉至少存在一个部位的躯体疼痛)、1035例未合并躯体疼痛(NDP组)。采用逐步logistic回归分析探讨抑郁症状合并躯体疼痛的相关因素。结果:2370例有抑郁症状的老年人中,合并躯体疼痛的检出率为56.33%。Logistic回归分析结果显示,女性(OR=1.45,95%CI:1.22~1.72)、农村户口(OR=2.32,95%CI:1.83~2.95)、患慢性疾病(OR=2.35,95%CI:1.84~2.99)、健康自评越差(健康自评一般OR值为2.09,95%CI:1.69~2.60;健康自评差OR值为3.33,95%CI:2.64~4.20)是老年人抑郁症状合并躯体疼痛的危险因素;年龄≥75岁(OR=0.72,95%CI:0.57~0.92)是老年人抑郁症状合并躯体疼痛的保护性因素。结论:抑郁症状合并躯体疼痛是我国老年人常见症状之一。女性、年龄大、农村人口、患有其他慢性疾病和健康自评状况较差是抑郁症状合并躯体疼痛的相关因素。     

北京某综合大学一年级学生自杀意念影响因素分析

目的: 调查大学生自杀意念的风险因素,探讨干预策略.方法: 采用整群抽样法,对北京某综合大学9个院系的所有一年级学生进行现况调查,使用Beck抑郁问卷、Beck焦虑问卷、Beck无望问卷、青年健康危害行为问卷(YRBS)、人格障碍诊断问卷-4(PDQ-4)和自编的一般情况问卷调查大学生自杀意念及相关心理行为问题.采用多因素logistic回归分析对一学年内自杀意念和一周内自杀意念的影响因素进行分析.结果: 共2055人填写了问卷,一学年内自杀意念的报告率8.1%,危险因素按OR值大小排列依次为有物质滥用(OR=4.37,95%CI:2.27-8.41)、一学年内有过明显抑郁情绪(OR=3.21,95%CI:2.20-4.68)、一学年内使用过远程求助(OR=1.78,95%CI:1.13-2.81)、一周内存在明显抑郁情绪(OR=2.14,95%CI:1.36-3.37)、分裂样人格因子分(OR=1.21,95%CI:1.07-1.37)、边缘人格因子分(OR=1.23,95%CI:1.09-1.38);一周内自杀意念的报告率5.5%,危险因素按OR值大小排列依次为一周内存在明显抑郁情绪(OR=4.62,95%CI:2.86-7.46)、阳性精神障碍家族史(OR=2.96,95%CI:1.34-6.56)、一学年内有过明显的抑郁情绪(OR=2.35,95%CI:1.49-3.69)、女性(OR=1.65,95%CI:1.09-2.52)、边缘人格因子分(OR=1.50,95%CI:1.30-1.72)、分裂型人格因子分(OR=1.17,95%CI:1.03-1.34).文科专业显示为一学年内自杀意念的保护因素(OR=0.63,95%CI:0.41-0.95).大一学生一学年内寻求精神卫生服务的比例占12.5%,9.8%使用远程求助方式.在使用当面求助方式上女性多于男性(4.8%/2.9%,x2=4.42,P:0.035);报告有自杀意念者一学年内总体求助、当面求助、远程求助比例均高于无自杀意念者(22.5%/11.3%、7.4%/3.2%、18.2%/8.9%,x2=23.0、10.3、19.7,P＜0.01).结论: 大学生自杀风险的筛查指标除自杀意念外还应考虑纳入抑郁、物质滥用、人格特点、阳性精神障碍家族史.大学生精神卫生服务宜从鼓励求助行为、主动提供延伸式服务、大力发展网络精神卫生服务三方面人手,提高服务质量.     

孕妇产前抑郁焦虑的危险因素

目的:探讨孕妇产前抑郁、焦虑的相关危险因素,为产前抑郁、焦虑的早期筛查及临床干预提供理论支持。方法:选取昆明市妇幼保健院产前检查的孕妇2112人,采用爱丁堡产后抑郁量表(EPDS)、焦虑自评量表(SAS)于孕28周对其进行问卷调查。采用非条件logistic回归分析探讨产前抑郁、焦虑症状的相关危险因素。结果:孕28周抑郁症状检出率为25.4%,焦虑症状检出率为6.6%。Logistic回归分析显示,抑郁症状的危险因素为低年龄(OR=0.80,95%CI:0.68~0.94)、孕期非坚持工作(OR=1.18,95%CI:1.02~1.36)、对居住环境不满意(OR=1.50,95%CI:1.23~1.83)、期望生男孩(OR=0.86,95%CI:0.77~0.96)、非独子(OR=1.37,95%CI:1.06~1.76)、非计划内怀孕(OR=1.38,95%CI:1.10~1.72);焦虑症状的危险因素为不满意居住环境(OR=1.64,95%CI:1.19~2.26)、与丈夫关系不融洽(OR=2.01,95%CI:1.20~3.37)、非计划内怀孕(OR=1.50,95%CI:1.05~2.14)。结论:本研究提示,年龄越小、孕期未坚持工作、对居住环境不满意、期望生男孩、孕妇非独子、非计划内怀孕的孕妇,越易患产前抑郁症;对居住环境不满意、与丈夫关系不融洽、非计划内怀孕的孕妇,越易患产前焦虑症。     

新型冠状病毒肺炎疫情期间民众抑郁状况调查

目的:了解民众在新型冠状病毒肺炎疫情期间的抑郁状况。方法:2020年2月16日-22日以网络调查表的形式开展横断面调查,采用患者健康问卷抑郁症状群量表(PHQ-9)筛查民众在疫情期间的抑郁症状,采用视觉模拟标尺(VAS)评估民众在疫情发生前后的抑郁程度。结果:民众在疫情期间的抑郁症状检出率为36.5%;饮酒(OR=1.52,95%CI:1.15～2.02)为抑郁症状的危险因素,年龄45～65岁(OR=0.62,95%CI:0.41～0.95)、已婚(OR=0.53,95%CI:0.40～0.71)为抑郁症状的保护性因素;民众在疫情发生前后抑郁程度VAS评分分别为1(0,18)、5(0,24),疫情发生后高于疫情发生前(P0.001)。结论:新型冠状病毒肺炎疫情期间超过三分之一的民众存在抑郁症状,饮酒为抑郁症状的危险因素。     

外伤住院患者创伤后应激障碍症状的相关因素

目的:探讨外伤住院患者创伤后应激障碍症状(PTSD)的相关因素。方法:选取武汉市两家医院外伤住院患者426例,采集一般人口学资料,采用社会支持评定量表评估社会支持情况,采用抑郁自评问卷(BDI)评估抑郁症状,采用PTSD自评量表评定(PTSD)症状。结果:PTSD症状的检出率为24.2%(103/426),家人关心减少(OR=2.47,95%CI:1.35~4.53)、入院时意识昏迷(OR=3.02,95%CI:1.39~6.54)、交通伤(OR=2.31,95%CI:1.31~4.05)、院内感染(OR=3.38,95%CI:1.31~8.74)、焦虑(OR=4.31,95%CI:1.11~16.74)、噩梦(OR=25.34,95%CI:5.30~121.31)、有些担心/很担心/非常担心死亡(OR=3.89/3.61/2.43,95%CI:1.59~9.53/1.32~9.92/0.86~6.84)和抑郁症状(OR=7.24,95%CI:3.38~15.49)是PTSD的危险因素。结论:家人关心减少、入院时意识昏迷、交通伤、院内感染、焦虑、噩梦、担心死亡和出现抑郁症状的外伤患者可能更容易出现PTSD。     

HIV阳性男男性行为者的抑郁焦虑状况

目的:了解我国HIV阳性男男性行为人群(MSM)的抑郁、焦虑状况,探讨抑郁、焦虑的相关因素。方法:在MSM社区HIV感染者小组的帮助下,在HIV阳性MSM中采用"滚雪球"的方法,共招募HIV阳性MSM 600人,采用电子调查问卷进行调查,获有效问卷541份。使用自编HIV阳性MSM人群健康状况调查表调查研究对象的社会人口学特征及健康行为等,流调中心用抑郁量表(CES-D)和焦虑自评量表(SAS)调查抑郁(CES-D评分≥16分者为有抑郁症状)、焦虑(SAS评分≥50分者为有焦虑症状)状况。结果:研究对象抑郁、焦虑症状检出率分别为44.7%(242/541)和25.1%(136/541)。多因素非条件logistic回归分析表明,抑郁症状的危险因素包括最近1年考虑过自杀(OR=3.31,95%CI:1.73~5.34)、未将HIV感染状况告知男性固定性伴(OR=0.47,95%CI:0.30~0.73)和被歧视经历评分高(OR=1.19,95%CI:1.11~1.29);与月收入≤1500元者相比,月收入为5000元者有抑郁症状的可能性降低(OR=0.34,95%CI:0.17~0.71)。焦虑症状危险因素包括最近1年考虑过自杀(OR=2.43,95%CI:1.40~4.21)、接受抗病毒治疗(OR=1.74,95%CI:1.06~2.84)和被歧视经历评分高(OR=1.12,95%CI:1.05~1.20);与月收入≤1500元者相比,月收入为5000元者检出焦虑症状的可能性降低(OR=0.44,95%CI:0.20~0.94)。结论:本研究提示HIV阳性MSM人群抑郁或焦虑症状检出率高,需要引起重视;降低社会歧视、促进性伴交流与支持、改善经济状况可能有助于提高HIV阳性MSM的心理健康水平。     

新冠肺炎疫情期间医务人员与非医务人员焦虑抑郁水平及相关因素

目的:探索新冠肺炎疫情暴发期间医务人员与非医务人员焦虑抑郁水平及相关因素。方法:通过微信公众号方式发放在线问卷,共调查医务人员170名,非医务人员217名。内容包括一般情况调查表、广泛性焦虑量表(GAD-7)、患者健康问卷(PHQ-9)和心理弹性量表(CD-RISC-10),采用logistic回归分析焦虑、抑郁情绪的相关因素。结果:医务人员中抑郁情绪检出率42.9%,焦虑情绪检出率46.5%。非医务人员抑郁情绪检出率62.7%,焦虑情绪检出率52.5%。在所有被调查者中,非医务人员(OR=0.58,95%CI:0.36～0.93,P<0.05)是抑郁情绪的危险因素,接触(疑似)感染者(OR=2.63,95%CI:1.43～4.85,P<0.01)是焦虑情绪的危险因素。心理弹性差是抑郁情绪(医务人员：OR=10.36,95%CI:3.46～31.05,P<0.001,非医务人员：OR=17.14,95%CI:6.39～45.97,P<0.001)和焦虑情绪(医务人员：OR=14.30,95%CI:4.68～43.69,P<0.001,非医务人员：OR=11...     

天津市18岁及以上社区人群睡眠质量调查

目的:了解天津市18岁及以上居民睡眠质量及相关因素。方法:调查对象来源于2011年7月-12月进行的天津市精神障碍流行病学调查项目,有11618名18岁及以上社区居民完成匹兹堡睡眠质量指数量表(PSQI)对睡眠质量的评估,以及一般健康问卷(GHQ-12)对是否可能存在心理障碍的筛查。PSQI总分7分为低睡眠质量。用χ2检验分析各变量组间低睡眠质量检出率的差异,多因素logistic回归分析睡眠质量的相关因素。结果:11618人中低睡眠质量980人,调整后天津市低睡眠质量的检出率为6.6%。Logistic回归分析显示:女性(OR=1.47,95%CI:1.19~1.82)、年龄越大(30~39岁OR值1.72,95%CI:1.10-2.69;40~49岁OR值2.55,95%CI:1.66-3.91;50~59岁OR值4.41,95%CI:2.85-6.83;60~69岁OR值5.34,95%CI:3.32-8.59;70岁及以上OR值5.40,95%CI:3.21-9.08)、医疗花费为自费(OR=1.52,95%CI:1.15~2.00)、职业为失业/无业(OR=1.46,95%CI:1.05~2.03)或离/病退(OR=1.45,95%CI:1.02~2.06)、吸烟(OR=1.49,95%CI:1.22~1.83)、因躯体疾病难以从事日常工作或活动(OR=2.30,95%CI:1.85~2.85)、GHQ-12得分≥4分(OR=6.51,95%CI:5.46~7.46)为低睡眠质量的危险因素。结论:天津市18岁以上居民低睡眠质量的检出率虽然较同类研究低,但睡眠问题依然值得关注。女性、年龄较大、医疗自费、无职业、有躯体疾病及可能存在心理障碍是低睡眠质量的相关因素。     

十堰地区孕妇抑郁症状调查及相关风险因素

目的:调查分析十堰地区孕妇抑郁症状及影响的相关因素,为该地区孕产妇的心理保健提供依据。方法:采用流行病学研究中心抑郁量表(CES-D)对十堰地区妊娠期女性进行为期5年的调查与评价,分析十堰市妊娠期女性的心理健康异常的相关影响因素。结果:共380例产妇进行了心理健康状况调查分析,所有孕妇可能存在抑郁症状的共有84人,总阳性率为22.1%,其中健康组的稳定职业、家庭人均收入≥3000、医保或公费支付、产次≥1次和孕前保健的比例显著高于抑郁组(P0.05),而抑郁组孕妇的有流产经历比例显著高于健康组(P0.05),其中家庭人均收入(OR:3.234,95%CI:1.422~4.245)、产次(OR:2.134,95%CI:1.022~3.523)、流产经历(OR:2.342,95%CI:1.677~4.231)、孕前保健(OR:4.562,95%CI:1.345~7.234)均为孕妇合并抑郁症状的显著影响因素。结论:十堰地区的孕妇普遍存在抑郁情绪的症状,不同孕妇的家庭人均收入、产次、流产经历、孕前保健是影响孕妇合并抑郁症状的主要因素。     

贫血与产后抑郁关系的meta分析

目的:系统评价产妇贫血与产后抑郁的关系。方法:检索PubMed、Web of Science、Embase、Cochrane Library、CINAHL Plus、PsycINFO、中国生物医学文献数据库、中国知网、万方、维普数据库中探讨产妇贫血与产后抑郁关系的研究,检索时限均为建库至2020年2月20日,并对纳入的文献进行质量评价与数据提取,采用RevMan 5.3与Stata 14.0软件进行meta分析。结果:最终纳入8篇文献,共78 637例患者。纳入文献质量评价均在中等及以上。meta分析显示产妇贫血与产后抑郁呈正关联(OR=2.08,95%CI:1.55~2.80,P<0.001);同时,亚组分析显示,不同地区[欧洲(OR=2.91)、亚洲(OR=1.82)]、抑郁评估期[产后6周及以下(OR=1.93)、产后6周以上(OR=2.48)]、贫血评估期[产后6周及以下(OR=2.17)、产后6周以上(OR=2.02)]、产妇贫血界定标准[Hb (OR=1.93)、其他(OR=2.48)]、产妇抑郁症状测量工具[EPDS (OR=2.01)、其他(OR=2.64)]中产妇贫血均与产后抑郁呈正关联。结论:产妇贫血与产后抑郁的风险增加有关。     

Longitudinal investigation of depression outcomes in primary care in six countries: the LIDO study. Functional status,health service use and treatment of people with depressive symptoms

BACKGROUND: Screening surveys of depressive symptoms were conducted among primary care patients at six sites in different countries. The LIDO Study was designed to assess quality of life and economic correlates of depression and its treatment in culturally diverse primary health care settings. This paper describes: (1) the association between depressive symptoms and functional status, global health-related quality of life (QoL), and use of general health services across different cultural settings; and (2) among subjects with depressive symptoms, the factors associated with recent treatment for depression. METHODS: Subjects aged 18 to 75 were recruited from participating primary care facilities in Be'er Sheva (Israel), Porto Alegre (Brazil), Melbourne (Australia), Barcelona (Spain), St Petersburg (Russian Federation) and Seattle (USA). Depressive symptoms were measured using the CES-D. Also administered were the SF-12, global questions on QoL, selected demographic and social measures, and questions on recent treatment for depression, use of health care services, and lost workdays. RESULTS: A total of 18,489 patients were screened, of whom 37% overall (range 24-55%) scored > or = 16 on the CES-D and 28% (range 17-42%) scored > or = 20. Overall, 13% reported current treatment for depression (range 4 to 23%). Patients with higher depressive symptom scores had worse health, functional status, QoL, and greater use of health services across all sites. Among those with a CES-D score > or = 16, subjects reporting treatment for depression were more likely than those reporting no treatment to be dissatisfied with their health (except in St Petersburg), and to have higher depressive symptom scores. CONCLUSIONS: Higher depressive symptom scores in primary care patients were consistently associated with poorer health, functional status and QoL, and increased health care use, but not with demographic variables. The likelihood of treatment for depression was associated with perceptions of health, as well as severity of the depression.     

北京地区更年期妇女抑郁症状调查

目的：了解北京地区更年期妇女抑郁症状发生情况及相关因素。方法：在北京地区十八个区(县)采取分层整群概率比率的方法抽取7232名40—65岁更年期妇女，对其抑郁症状发生情况采用Zung抑郁自评表进行调查。结果：6786份有效资料进入分析。其中，有抑郁症状者223例，发生率3．65％；抑郁症状与各种更年期症状的发生、妊娠次数多少(特别是流、早产次数)、已绝经时间长短、高血压、骨折、与丈夫关系不和睦、吸烟等因素有明显正相关性；但与精神病家族史无关。结论：更年期抑郁症状严重影响妇女健康，应采取有针对性的措施，以减少抑郁症状对更年期妇女的干扰，避免更严重的精神疾患发生。     

Prevalence and geographic disparity of depressive symptoms among middle-aged and elderly in China

BACKGROUND: To evaluate the prevalence of and risk factors for depressive symptoms among middle-aged and elderly Chinese in northern and southern China. METHODS: A population-based cross-sectional survey was performed in Beijing and Shanghai. Participants included 3289 community residents aged 50-70. Socio-demographic, lifestyle and health-related information were obtained by a standardized questionnaire. Clinically relevant depressive symptoms were assessed by the Center for Epidemiological Studies of Depression Scale (CES-D). RESULTS: The prevalence of depressive symptoms in the total study population was 9.5% (6.7% for men and 11.7% for women), and it was significantly higher in participants from Beijing than those from Shanghai (14.9% vs. 4.1%, P < 0.001). Multivariate logistic regression analyses indicated that this geographic disparity was independent of gender, age, marital status, living status, education level, health status, mobility, social activities and medical insurance (odds ratio, 3.94; 95% confidence interval, 2.86-5.40). LIMITATIONS: No clinical diagnostic validation was performed and the prevalence might be underestimated due to our exclusion criteria. CONCLUSIONS: Approximately one in ten middle-aged and elderly Chinese might suffer from depressive symptoms. Furthermore, the prevalence is substantially higher among residents in the north of China compared to the south. Prospective studies are required to confirm the results and identify the major risk factors contributing to this geographic disparity.     

Antenatal risk factors for postnatal depression: a large prospective study

BACKGROUND: This study measured antenatal risk factors for postnatal depression in the Australian population, both singly and in combination. Risk factor data were gathered antenatally and depressive symptoms measured via the beyondblue National Postnatal Depression Program, a large prospective cohort study into perinatal mental health, conducted in all six states of Australia, and in the Australian Capital Territory, between 2002 and 2005. METHODS: Pregnant women were screened for symptoms of postnatal depression at antenatal clinics in maternity services around Australia using the Edinburgh Postnatal Depression Scale (EPDS) and a psychosocial risk factor questionnaire that covered key demographic and psychosocial information. RESULTS: From a total of 40,333 participants, we collected antenatal EPDS data from 35,374 women and 3144 of these had a score >12 (8.9%). Subsequently, efforts were made to follow-up 22,968 women with a postnatal EPDS. Of 12,361 women who completed postnatal EPDS forms, 925 (7.5%) had an EPDS score >12. Antenatal depression together with a prior history of depression and a low level of partner support were the strongest independent antenatal predictors of a postnatal EPDS score >12. LIMITATIONS: The two main limitations of the study were the use of the EPDS (a self-report screening tool) as the measure of depressive symptoms rather than a clinical diagnosis, and the rate of attrition between antenatal screening and the collection of postnatal follow-up data. CONCLUSIONS: Antenatal depressive symptoms appear to be as common as postnatal depressive symptoms. Previous depression, current depression/anxiety, and low partner support are found to be key antenatal risk factors for postnatal depression in this large prospective cohort, consistent with existing meta-analytic surveys. Current depression/anxiety (and to some extent social support) may be amenable to change and can therefore be targeted for intervention.     

Associations between cod liver oil use and symptoms of depression: the Hordaland Health Study

BACKGROUND: Clinical trials suggest that omega-3 fatty acids improve the outcome of depression. This study aimed to evaluate the association between intake of cod liver oil, rich in omega-3 fatty acids, and high levels of symptoms of depression and anxiety in the general population. METHODS: We used data from the "The Hordaland Health Study '97-'99" (HUSK), a population based cross-sectional health survey from Norway including 21,835 subjects aged 40-49 and 70-74 years. Symptoms of depression and anxiety were measured by The Hospital Anxiety and Depression Scale (HADS). We used logistic regression to study associations. RESULTS: Among the participants, 8.9% used cod liver oil daily. A total of 3.6% had high levels of depressive symptoms. The prevalence of such depressive symptoms among the subjects who used cod liver oil daily was 2.5%, as compared to 3.8% in the rest of the population. The users of cod liver oil were significantly less likely to have depressive symptoms than non-users after adjusting for multiple possible confounding factors (odds ratio=0.71, 95% confidence interval 0.52 to 0.97). These factors included age, gender, smoking habits, coffee consumption, alcohol consumption, physical activity, and education. In addition, we found that the prevalence of high levels of depressive symptoms decreased with increasing duration (0-12 months) of cod liver oil use (multivariate adjusted test for trend, P=0.04). We were only able to study this latter association in a subset of the population aged 40-46 years. LIMITATIONS: Data are cross sectional. CONCLUSIONS: The findings indicate that regular use of cod liver oil is negatively associated with high levels of depressive symptoms in the general population.     

Depression in old age (75+), the PIKO study

BACKGROUND: Old people (75+) are underrepresented in studies on the prevalence of and risk factors for depression while the number of elderly people suffering from this mood disorder may be considerably higher than previously assumed. The role--if any--of age and gender in 'Geriatric Depression' is still unclear. METHODS: In this community-based study, prevalence of depressive symptomatology and risk indicators were assessed in 2850 participants aged 75 years or more. A clinically relevant level of depressive symptoms was defined as a score of > or =16 on the Centre for Epidemiologic Studies Depression scale (CES-D). Demographic data and questions related to physical and psychological health were recorded. Simple and multiple logistic regression techniques were used to determine the risk indicators (Odds Ratios, OR, with 95% confidence intervals, CI) with apparent importance to this population. RESULTS: The prevalence of depressive symptoms was assessed to be 31.1%. This is considerably higher than what has been found in younger elderly samples. The bivariate age effect was OR 1.05 (95% CI=1.03 to 1.07). Controlling for confounding, the effect of gender and age on depressive symptoms disappeared. CONCLUSIONS: Depressive symptoms are highly prevalent in the elderly population and increase with age. This increase seems to be attributable to age-related changes in risk factors rather than to ageing itself. With regard to the risk factors found, attention should perhaps be paid to functional disability, loneliness and apprehensiveness for falling since these risk indicators are amenable for improvement.     

广州市白云区2001年～2010年围产儿死亡分析及干预措施

目的对广州市白云区围产儿死亡相关因素进行分析和总结,探讨围产儿死亡率的变化及其影响因素,为降低围产儿死亡率制定相关的干预措施提供科学依据。方法回顾性分析广州市白云区2001年～2010年共10年间围产儿死亡评审资料。结果共有1653例围产儿死亡,平均死亡率为7.98‰,其中户籍人口为5.4‰,流动人口为8.8%（χ2=57.432,P〈0.001）;围产儿死亡率呈逐年下降趋势。影响围产儿死亡的因素有：覆盖全民的医疗保障系统不全面、产、儿科诊疗知识技能和医疗系统管理存在薄弱环节、孕期保健意识薄弱,围产保健管理有待加强。结论通过加强政府投入,建立健全孕产妇三级网络保健系统,特别加强对农村地区和流动人口的孕产妇管理;提高医疗机构产、儿科诊疗技能水平;提高产前诊断技术,减少出生缺陷;加强流动人口管理等措施,有效降低围产儿死亡率。     

Symptoms of depression in the Estonian population: prevalence, sociodemographic correlates and social adjustment

OBJECTIVE: The current study presents data on the prevalence of depressive symptoms in the Estonian population and examines associated sociodemographic factors and subjective aspects of social adjustment. METHOD: The data came from the Estonian Health Interview Survey where 4711 persons aged 15-79 were interviewed. This study included 4677 respondents who answered the Emotional State Questionnaire (EST-Q), a self-rating scale of depression and anxiety. Data on the sociodemographic factors and domains of social adjustment were derived from structured interviews. RESULTS: Depressive symptoms were observed in 11.1% of the respondents. Depressiveness was more common among women, in older age groups, among those not married, in ethnic groups other than Estonians, in lower income groups, and among the unemployed and economically inactive respondents. Depressive subjects were less satisfied, had a more pessimistic prognosis about the future and lower self-rated health. A low level of perceived control was a significant correlate of depression. The association of depressiveness with poor subjective social adjustment remained significant even after controlling for objective circumstances. LIMITATIONS: Depression was identified by a self-rate questionnaire, therefore results can not be generalized to clinical depression without caution. CONCLUSION: Depressive symptoms in the Estonian population were strongly related to socioeconomic functioning. Results emphasize that subjective social adjustment and perceived control are important characteristics of depression and should be considered in assessment and treatment.     

Impact of depressive symptoms on adult asthma outcomes.

BACKGROUND: Psychological disorders, including depression, are common in adults with asthma. Although depression is treatable, its impact on longitudinal asthma outcomes is not clear. OBJECTIVE: To elucidate the impact of depressive symptoms on patient-centered outcomes and emergency health care use in adults with asthma. METHODS: We conducted a prospective cohort study of 743 adults with asthma who were recruited after hospitalization for asthma. Depressive symptoms were defined as having a score of 16 or more on the Center for Epidemiologic Studies Depression Scale. We examined the impact of depressive symptoms on patient-centered outcomes (validated severity-of-asthma score, Marks Asthma Quality of Life Questionnaire, and 12-Item Short-Form Health Survey physical component summary score) and on future emergency health care use for asthma ascertained from computerized databases. RESULTS: The prevalence of depressive symptoms was 18% (95% confidence interval [CI], 15%-21%) among adults with asthma. Depressive symptoms were associated with greater severity-of-asthma scores after controlling for age, sex, race/ ethnicity, educational attainment, and cigarette smoking (mean score increment, 2.6 points; 95% CI, 1.8-3.4 points). Furthermore, depressive symptoms were associated with poorer asthma-specific quality of life (mean score increment, 19.9 points; 95% CI, 17.7-22.1 points) and poorer physical health status (mean score decrement, 3.7 points; 95% CI, 1.5-5.8 points). Depressive symptoms were associated with a greater longitudinal risk of hospitalization for asthma (hazard ratio, 1.34; 95% CI, 0.98-1.84). After controlling for differences in preventive care for asthma, the relationship was stronger (hazard ratio, 1.45; 95% CI, 1.05-2.0). CONCLUSION: Depressive symptoms are common in adults with asthma and are associated with poorer health outcomes, including greater asthma severity and risk of hospitalization for asthma.     

Depressive symptoms favor abundant growth of salivary lactobacilli.

OBJECTIVE: The purpose was to study the growth of lactobacilli in subjects with depressive symptoms in the total 55-year-old population of Oulu (a medium-sized town in Finland); 780 people participated. METHODS: The dental examination included measurements of salivary lactobacillus growth with the Dentocult-LB method; measurements of salivary flow rate, pH, and buffering capacity; and assessment of oral health status. Depressive symptoms were determined with the Zung Self-Rating Depression Scale (ZSDS). Participants were also asked about their health, medication, smoking, and dietary habits. RESULTS: The prevalence of high lactobacillus counts (> or =100,000 CFU/ml) was 22% among women and 31% among men (p = .02). Thirty-seven percent of the subjects with a high rate of depressive symptoms (ZSDS score of > or = 40) and 23% of those with an ZSDS score of < or = 39 had high counts of lactobacilli (p = .003). A logistic regression analysis with improvement of goodness of fit was made to confirm the relation between abundant lactobacilli and a high rate of depressive symptoms. After the confounding factors had been added stepwise into the logistic regression model, depressive symptoms were still significantly associated with abundant lactobacillus growth. CONCLUSIONS: The association between high lactobacillus counts and depressive symptoms suggests that depressed subjects are at risk of having caries and possibly other dental diseases that should be recognized in the treatment of these patients.