Relationship Between Depressive State and Treatment Characteristics of Acute Cervical Spinal Cord Injury in Japan

Background

Few studies have assessed whether treatment of acute cervical spinal cord injury (SCI) patients contributes to depression.

Methods

Using an administrative database, we assessed patients for whom the diagnosis was unspecified injuries of cervical spinal cord (International Classification of Diseases and Injuries-10th (ICD-10) code; S14.1). We categorized patients with codes for depressive episode (ICD-10 code; F32) or recurrent depressive disorder (F33), or those prescribed antidepressants (tricyclic, tetracyclic, Selective Serotonin Reuptake Inhibitors, Serotonin Noradrenaline Reuptake Inhibitors, Trazodone, Sulpiride, or Mirtazapine) as having a depressive state. We compared the rate of each acute treatment between the depressive state group and the non-depressive state group using chi-square tests, and a multiple logistic regression model was used to identify the association between the acute treatment and depressive state.

Results

There were 151 patients who were judged to be in a depressive state, and the other 2115 patients were categorized into the non-depressive state group. Intervention of intravenous anesthesia, tracheostomy, artificial respiration, and gastrostomy had a significant positive correlation with depressive state. Multiple logistic regression analysis showed that tracheostomy (odds ratio [OR] 2.18; 95% confidence interval [CI], 1.09–4.38) and artificial respiration (OR 2.28; 95% CI, 1.32–3.93) were significantly associated with depressive state, and men had a 36% reduction in the risk of depressive state compared with women (OR 0.64; 95% CI, 0.44–0.94), whereas age, wound-treatment, all of the orthopedic procedures, intravenous anesthesia, and gastrostomy were not associated with depressive state.

Conclusions

These findings suggest that tracheostomy, artificial respiration and female gender in the acute phase after cervical SCI might be associated with the development of depression.Key words: depression, spinal cord injury, administrative database     

Cigarette smoking and adherence to antihypertensive medication in patients from primary care

Abstract

Background: There are no great differences in the symptom profiles of depression between the genders in observer rating scales, but women self-report more symptoms. Objective: To compare gender differences in symptom profiles of clinical depression in primary care with a short self-report depression scale and an observer-rated scale for social functioning. Methods: A sample of 436 primary care patients aged 18–64 years were screened using the Depression Scale (DEPS) and interviewed using the Present State Examination (PSE). Level of social functioning was also assessed. Sum scores and single items of DEPS were compared between men and women in the groups of both depressive and non-depressive patients, and the interactions between gender and depression were analysed. Results: Depressive men scored poorer on both instruments. Feeling that everything is an effort and feeling worthless were typical for depressive men. Feeling blue was more typical for non-depressive women than for non-depressive men.

Conclusion: In this sample of primary care patients, there were differences in the symptom profiles of depression between men and women. Depressive men more commonly had serious symptoms than depressive women. Clinically, male depression deserves more attention. The psychosocial profile of public primary care patients in Finland warrants further research.     

A descriptive analysis of quality of life using patient-reported measures in major depressive disorder in a naturalistic outpatient setting

Purpose

Major depressive disorder (MDD) negatively impacts different aspects of an individual’s life leading to grave impairments in quality of life (QOL). We performed a detailed analysis of the interaction between depressive symptom severity, functioning, and QOL in outpatients with MDD in order to better understand QOL impairments in MDD.

Methods

This cross-sectional study was conducted with 319 consecutive outpatients seeking treatment for DSM-IV-diagnosed MDD at an urban hospital-based outpatient clinic from 2005 to 2008 as part of the Cedars-Sinai Psychiatric Treatment Outcome Registry, a prospective cohort study of clinical, functioning, and patient-reported QOL outcomes in psychiatric disorders using a measurement-based care model. This model utilizes the following measures: (a) Depressive symptom severity: Quick Inventory of Depressive Symptomatology-Self Report (QIDS-SR); (b) Functioning measures: Global Assessment of Functioning (GAF), Sheehan Disability Scale (SDS), Work and Social Adjustment Scale, and the Endicott Work Productivity Scale; and (c) Quality of Life measure: Quality of Life, Enjoyment, and Satisfaction Questionnaire—Short Form (Q-LES-Q).

Results

QOL is significantly impaired in MDD, with a mean Q-LES-Q score for this study population of 39.8 % (SD = 16.9), whereas the community norm average is 78.3 %. Regression modeling suggested that depressive symptom severity, functioning/disability, and age all significantly contributed to QOL. QIDS-SR (measuring depressive symptom severity), GAF, and SDS (measuring functioning/disability) scores accounted for 48.1, 17.4, and 13.3 % (semi-partial correlation values) of the variance in Q-LES-Q, respectively.

Conclusions

Our results show that impairment of QOL increases in a monotonic fashion with depressive symptom severity; however, depression symptom severity only accounted for 48.1 % of the QOL variance in our patient population. Furthermore, QOL is uniquely associated with measures of Functioning. We believe these results demonstrate the need to utilize not only Symptom Severity scales, but also Functioning and Quality of Life measures in MDD assessment, treatment, and research.     

Impact of psychosocial job stress on non-fatal occupational injuries in small and medium-sized manufacturing enterprises

BACKGROUND: Workers involved in manufacturing are known to comprise a high-risk population for occupational injury, and this risk is greater in small and medium-sized enterprises (SMEs). The purpose of this study was to examine the association between psychosocial job stress and occupational injuries among workers in SMEs. METHODS: One thousand forty-nine men and 721 women from 244 SMEs participated in this study. Perceived job stress was evaluated with the Japanese version of the generic job stress questionnaire, which covered 14 job stress variables. Occupational injury was assessed by self-report during the last 1-year period. RESULTS: Workers with high quantitative workload (odds ratio [OR] = 1.55 for men, 1.62 for women), high cognitive demands (OR = 1.70 for men, 1.53 for women), and low job satisfaction (OR = 1.33 for men, 1.93 for women) had a significantly increased risk of occupational injury in the multivariate model. High variance in workload (OR = 1.70) and high job future ambiguity (OR = 1.35) in men, and low job control (OR = 2.04) and high intragroup conflict (OR = 1.66) in women were significantly associated with occupational injury. In manufacturing/production workers, high quantitative workload (OR = 1.91), high variance in workload (OR = 2.02), and high depressive symptoms (OR = 1.55) were significantly associated with injury in men, while low social support from colleagues (OR = 2.36) or family (OR = 2.51) was related to injury in women. CONCLUSIONS: These data point to an independent relationship between psychosocial job stress and self-reported occupational injury in SMEs.     

孕晚期静坐行为与抑郁和妊娠相关焦虑的关系

目的 探究北京地区孕晚期妇女总静坐行为和不同类型静坐行为与抑郁和妊娠相关焦虑的关系.方法 以中国孕产妇队列研究(CPWCS)·协和项目中的576例孕晚期妇女为研究对象.CPWCS项目自2018年5月起,在北京市通州区妇幼保健院采用方便抽样的方法纳入年龄≥16岁,孕5～12周的孕早期妇女,并进行基线调查.于研究对象孕晚期...     

Depression and retirement in late middle-aged U.S. workers

OBJECTIVE: To determine whether late middle-aged U.S. workers with depression are at an increased risk for retirement. DATA SOURCE: Six biennial waves (1992-2002) of the Health and Retirement Study, a nationally representative panel survey of noninstitutionalized 51-61-year-olds and their spouses started in 1992. STUDY DESIGN: Workers aged 53-58 years in 1994 were followed every 2 years thereafter, through 2002. Depression was coded as lagged time-dependent variables measuring active depression and severity of depression. The main outcome variable was a transition to retirement which was measured using two distinct definitions to capture different stages in the retirement process: (1) Retirement was defined as a transition out of the labor force in the sample of all labor force participants (N=2,853); (2) In addition a transition out of full time work was used as the retirement definition in the subset of labor force participants who were full time workers (N=2,288). PRINCIPAL FINDINGS: In the sample of all labor force participants, the presence of active depression significantly increased the hazard of retirement in both late middle-aged men (adjusted OR: 1.37 [95 percent CI 1.05, 1.80]) and women (adjusted OR: 1.40 [95 percent CI 1.10, 1.78]). For women, subthreshold depression was also a significant predictor of retirement. In the sample of full time workers, the relationship between depression and retirement was considerably weaker for women yet remained strong for men. CONCLUSIONS: Depression and depressive symptoms were significantly associated with retirement in late middle-aged U.S. workers. Policymakers must consider the potentially adverse impact of these labor market outcomes when estimating the cost of untreated depression and evaluating the value of interventions to improve the diagnosis and treatment of depression.     

Depressive symptoms in Hispanic and non-Hispanic White rural elderly: the San Luis Valley Health and Aging Study

Literature on depression in rural and Hispanic elderly adults is sparse. This report describes the prevalence of depressive symptoms in 1,151 community-dwelling, Hispanic and non-Hispanic White participants in the San Luis Valley Health and Aging Study, conducted in rural Colorado during 1993-1995. The prevalence and odds ratios of high depressive symptoms, defined as a Center for Epidemiologic Studies Depression Scale score of > or = 16, were calculated. The crude prevalence of high depressive symptoms was 11.4% (95% confidence interval: 9.6, 13.6). Female gender, chronic diseases, dissatisfaction with social support, living alone, and lower income and education were associated with depressive symptoms. There were no ethnic differences in the men. The age-adjusted odds ratio of depressive symptoms in Hispanic women compared with that of non-Hispanic White women was 2.11 (95% confidence interval: 1.32, 3.38). After adjustment for multiple sociodemographic and health risk factors, the odds ratio in Hispanic women was 2.12 (95% confidence interval: 1.19, 3.80). Higher depressive symptoms in Hispanic women varied by acculturation level. The odds ratio in the high acculturation stratum was 1.56 (95% confidence interval: 0.75, 3.27) and in the low acculturation stratum was 2.51 (95% confidence interval: 1.11, 5.70). A lower acculturation level may increase the risk for depression in older Hispanic women.     

The association of depression and angina pectoris across 47 countries: findings from the 2002 World Health Survey

Comorbid depression predicts poor health outcomes in patients with angina pectoris (AP). However, epidemiological data on the depression-AP comorbidity is limited and largely restricted to studies from Western countries, making generalizability to other regions uncertain. We aimed to provide additional epidemiological data for non-Western as well as Western countries. The present study used population-based data gathered in 47 countries from four continents (Africa, Asia, South America, and Europe) included in the cross-sectional 2002 WHO World Health Survey. Self-reported indicators of depression included: (a) its diagnosis, (b) its treatment, and (c) seven symptom items to determine presence of a major depressive episode. Similarly, information on AP comprised (a) a self-reported diagnosis, (b) self-reported AP treatment, (c) and a definition according to the WHO Rose questionnaire. In primary analyses, we operationalized depression or AP as positive if any of the respective indicators was present. Associations were estimated by multivariate logistic regression. In the entire sample (n = 213,264), the odds of AP were more than doubled among those with depression [odds ratio (OR) = 2.60, 95 % confidence interval = 2.36, 2.87] versus those without depression. These positive associations were replicated across all continents and were observed in both men and women. Likewise, meaningful associations (ORs ≥ 1.5) were observed in virtually all individual countries (46/47). Application of different operationalizations of depression and AP confirmed the above findings, both in the entire sample and in continent-specific analyses. Our study extends the current evidence accrued in Western populations to non-Western populations. The co-occurrence of AP and depression appears to represent a universal phenomenon.     

Associations among postpartum depression, eating disorders, and perfectionism in a population-based sample of adult women

OBJECTIVE: The current study investigated associations among eating disorders, depressive symptoms during pregnancy and postpartum, and perfectionism in a population-based sample of women. METHOD: Females who reported > or = 1 pregnancy (N = 1,119) completed questionnaires assessing perfectionism, eating disorder symptomatology, and depression during pregnancy and postpartum. Information regarding participants' history of major depressive disorder (MDD) was also available from structured psychiatric interviews completed during a previous wave of data collection. RESULTS: Depressive symptoms during pregnancy and postpartum were high among women with a history of eating disorders. Both binge eating disorder (BED) and bulimia nervosa (BN) were positively associated with symptoms of postpartum depression (PPD), even when lifetime MDD was controlled. However, logistic regression indicated that women with a history of BN and BED are at particular risk of developing PPD symptomatology. Linear regression analyses conducted with the subset of the sample who endorsed a PPD screening item suggested that the severity of PPD symptomatology may be attributable to Concern Over Mistakes, a specific aspect of perfectionism. CONCLUSION: These results highlight the importance of assessing specific features of perfectionism. In addition, they suggest that women with BN, BED, or high Concern over Mistakes may be at particular risk of developing PPD symptoms, and could benefit from prenatal screening.     

Major depressive disorder and dysthymia in young adolescents.

A two-stage epidemiologic study conducted between 1986 and 1988 in the southeastern United States investigated the frequency of major depressive disorder and dysthymia in 12-14 year olds. In stage one, the Center for Epidemiologic Studies Depression Scale, a life event schedule, and a family cohesion scale were administered to a community sample of 3,283 adolescents. In stage two, 488 mother-child pairs were interviewed utilizing the Schedule for Schizophrenia and Affective Disorders in School Age Children. Although mean Center for Epidemiologic Studies Depression Scale scores were significantly higher in females (25.60) than in males (19.50), prevalence estimates based on a summary of mother and child symptom reports for Diagnostic and Statistical Manual of Mental Disorders, Third Edition, major depressive disorder were similar: 9.04% in males and 8.90% in females. The prevalences of dysthymia were 7.98% in males and 5.00% in females. Previous investigations have reported lower rates and a female preponderance of major depression. Disagreement between mothers and children regarding the presence of symptoms may explain this contradiction. Significant odds ratios were found between major depression and not living with both natural parents (odds ratio (OR) = 3.89), undesirable life events (OR = 1.09), and perceived family cohesion (OR = 0.96). Not living with both natural parents (OR = 14.67) and socioeconomic status (OR = 0.44) were significant correlates of dysthymia.     

Depression severity, diet quality, and physical activity in women with obesity and depression

Major depressive disorder (MDD) is prevalent in clinical weight-loss settings and predicts poor weight-loss outcomes. It is unknown whether the severity of depressive symptoms among those with MDD is associated with diet quality or physical activity levels. This knowledge is important for improving weight-loss treatment for these patients. It was hypothesized that more severe depression is associated with poorer diet quality and lower physical activity levels among individuals with obesity and MDD. Participants were 161 women with current MDD and obesity enrolled in the baseline phase of a weight-loss trial between 2007 and 2010. Depression severity was measured with the Beck Depression Inventory II. The Alternate Healthy Eating Index was applied to data from three 24-hour diet recalls to capture overall diet quality. Daily metabolic equivalents expended per day were calculated from three 24-hour physical activity recalls. Greater depression severity was associated with poorer overall diet quality (estimate=-0.26, standard error 0.11; P=0.02), but not with physical activity (estimate=0.07, standard error 0.05; P=0.18), in linear regression models controlling for income, education, depression-related appetite change, binge eating disorder, and other potential confounds. Associations with diet quality were primarily driven by greater intake of sugar (r=0.20; P<0.01), saturated fat (r=0.21; P<0.01), and sodium (r=0.22; P<0.01). More severe depression was associated with poorer overall diet quality, but not physical activity, among treatment-seeking women with MDD and obesity. Future studies should identify mechanisms linking depression to diet quality and determine whether diet quality improves with depression treatment.     

Lifetime Depression History and Sexual Function in Women at Midlife

We examined the association between lifetime depression history and sexual function in a community-based sample of midlife women. Specifically, 914 women aged 42-52 who were participants in the Study of Women's Health Across the Nation completed a self-report assessment of their sexual behaviors, sexual desire, sexual arousal, and sexual satisfaction over the past 6 months. On the basis of the Structured Clinical Interview for the DSM-IV , participants were categorized into 1 of 3 lifetime major depressive disorder (MDD) history groups: no MDD history, single episode MDD, and recurrent MDD. In line with previous reports, women with a history of recurrent MDD reported experiencing less frequent sexual arousal, less physical pleasure, and less emotional satisfaction within their current sexual relationships. Although the groups did not differ in their reported frequency of sexual desire or partnered sexual behaviors, lifetime depression history was associated with increased rates of self-stimulation (masturbation). Associations between lifetime depression history and lower levels of physical pleasure within partnered sexual relationships and higher rates of masturbation remained significant following control for current depressive symptoms, study site, marital status, psychotropic medication use, and lifetime history of anxiety or substance abuse/dependence disorder. Future research is needed to characterize the temporal and etiologic relationships among lifetime depressive disorder, current mood state, and sexual function in women across the lifespan.     

Correlates of Early Postpartum Depressive Symptoms

Background: Postpartum depressive symptoms negatively affect the quality of life and daily functioning of mothers and infants. Little research has examined the impact of situational factors such as physical symptom burden and function on early postpartum depressive symptoms. Objectives: To explore the association between situational factors and early postpartum depressive symptoms. To predict correlates of early postpartum depressive symptoms. Methods: Cross sectional telephone survey of 720 mothers between 2 and 6 weeks postpartum. Mothers reported on demographic factors, physical and psychological symptoms, daily function, infant behaviors, social support, and skills in managing infant and household. The association between these factors and postpartum depressive symptoms were investigated with bivariate and multivariable analyses. Results: Nearly, 39% of patients screened positive for depressive symptoms. Bivariate analyses showed symptomatic patients were more likely to be nonwhite, have lower incomes, less education, a past history of depression, have higher physical symptom burdens, more physical functional limitations, more infant colic, receive less social support, and have lower-self-efficacy scores as compared with patients without symptoms of depression. In a multivariable model predicting depressive symptoms, nonwhite race (odds ratio (OR) of 1.96, 95% confidence interval (CI) of 1.38, 2.78), more physical symptoms (OR 1.16, 95% CI 1.01, 1.32), infant colic (OR 1.79, 95% CI 1.29, 2.50) lack of social support (OR 0.90, 95% CI 0.86, 0.95), and lower self-efficacy scores (OR 0.90, 95% CI 0.86, 0.94) were associated with depressive symptoms. Conclusions: Nonwhite race, physical symptom burden, infant colic, lack of social support, and lower self-efficacy scores are associated with early postpartum depressive symptoms. Further research is needed to investigate whether providing social support and teaching skills to enhance self-efficacy will reduce the incidence of early postpartum symptoms of depression.The opinions, view, and conclusions expressed in this article are those of the authors and not necessarily those of the Robert Wood Johnson Foundation or Agency for Healthcare Research and Quality.     

A survey of depressive symptoms among South Korean adults after the Korean financial crisis of late 1997: prevalence and correlates

PURPOSE: We examined the prevalence of high levels of depressive symptoms and their association with sociodemographic and health characteristics in an urban Korean population following the financial crisis in late 1997. METHODS: Using data from a cross-sectional survey conducted in Ansan-city, Korea, from June 1999 to June 2000, we examined the prevalence and correlates of depressive symptoms in a randomly selected sample of 4897 (2531 male and 2366 female) subjects aged 18 to 92 years. The prevalence and odds ratios of "probable" and "definite" depressive symptoms, defined as a Center for Epidemiologic Studies Depression Scale (CES-D) score of > or = 16 and > or = 24, respectively, were calculated. RESULTS: The mean CES-D score and prevalence of "probable" and "definite" depression were significantly higher in women (15.63, 41.67%, and 12.05%, respectively) than in men (14.43, 35.05%, and 8.10%, respectively) (p < 0.0001). In multiple logistic regression analysis, being female, unemployed, unmarried, self-assessed as unhealthy, and having a low income were found to be significant predictors of "probable" and "definite" depressive symptoms in Korean adults. CONCLUSIONS: Although current data cannot be directly compared with those reported in the most recently published Korean data from 1994, considerably high mean CES-D score and prevalence of depression speculate that the Korean financial crisis of 1997 had an effect on the development of depressive symptoms in Korean adults.     

A Rural Perspective on Perinatal Depression: Prevalence, Correlates, and Implications for Help-Seeking Among Low-Income Women

ABSTRACT:  Context/Purpose: To examine a low-income sample of women in the rural Midwest (N = 1,086) who were screened for perinatal depression through the outreach and education activities within a Healthy Start Initiative project. Specifically, we describe the frequency and severity of depressive symptoms, explore social and demographic correlates of depression, and examine help-seeking through patterns of self-referral to a Healthy Start perinatal depression project in a rural, medically underserved community. Methods: Depression screening data using the Primary Care Evaluation of Mental Disorders (PRIME-MD) as well as intake records from the project were analyzed in a retrospective analysis to identify important demographic and psychosocial characteristics associated with elevated levels of depressive symptoms and help-seeking patterns. Findings: Thirty-six percent of screened women met criteria for major, minor, or subthreshold depression, with 13% meeting diagnostic criteria for major depression alone. Less than 8% were currently receiving any type of mental health services or treatment at screening. The most significant correlate of self-referral to the Healthy Start project was meeting symptom criteria for major depression, although minor depression, subthreshold depression, and status as low-income /Temporary Aid to Needy Families ( TANF)-eligible were all significantly associated with self-referral. Conclusions: The findings from this study highlight the potential significance of identifying and addressing the unmet mental health needs of low-income rural women during and around pregnancy. In addition, the study illustrates that low income, in addition to depressive symptoms, impacts mental health service delivery in this rural community with a fragmented mental health service infrastructure .     

Associations of depressive symptoms with regular leisure activity and family social support among Japanese workers

This study was performed to determine the associations of depressive symptoms with regular leisure activity and family social support among Japanese workers. The study participants consisted of 1,605 men and 348 women. Depressive symptoms were evaluated using the Center for Epidemiologic Studies Depression scale. Multiple logistic regression analysis was used to adjust for potentially associated variables. Depressive symptoms were associated with lack of regular leisure activity for men [odds ratio (OR) = 2.05, 95% confidence interval (CI) = 1.55-2.71] and for women (OR = 2.53, 95% CI = 1.30-4.95). Depressive symptoms were also associated with lack of family social support for men (OR = 1.87, 95% CI = 1.43-2.43). Although a cross-sectional study does not determine which factors are determinants or consequences, these findings suggest regular leisure activity for men and women and family social support for men are independently associated with depressive symptoms.     

Anxiety and Depression Symptoms Among Farmers: The HUNT Study,Norway

Agriculture has undergone profound changes, and farmers face a wide variety of stressors. Our aim was to study the levels of anxiety and depression symptoms among Norwegian farmers compared with other occupational groups. Working participants in the HUNT3 Survey (The Nord-Trøndelag Health Study, 2006–2008), aged 19–66.9 years, were included in this cross-sectional study. We compared farmers (women, n = 317; men, n = 1,100) with HUNT3 participants working in other occupational groups (women, n = 13,429; men, n = 10,026), classified according to socioeconomic status. We used the Hospital Anxiety and Depression Scale (HADS) to measure anxiety and depression symptoms. Both male and female farmers had higher levels of depression symptoms than the general working population, but the levels of anxiety symptoms did not differ. The differences in depression symptom levels between farmers and the general working population increased with age. In an age-adjusted logistic regression analysis, the odds ratio (OR) for depression caseness (HADS-D ≥8) when compared with the general working population was 1.49 (95% confidence interval [CI]: 1.22–1.83) in men and 1.29 (95% CI: 0.85–1.95) in women. Male farmers had a higher OR of depression caseness than any other occupational group (OR = 1.94, 95% CI: 1.52–2.49, using higher-grade professionals as reference). Female farmers had an OR similar to men (2.00, 95% CI: 1.26–3.17), but lower than other manual occupations. We found that farmers had high levels of depression symptoms and average levels of anxiety symptoms compared with other occupational groups.     

Depressive symptoms in the immediate postpartum period among Hispanic women in three U.S. cities

The aim of this was to examine rates and determinants of depressive symptomatology in the immediate postpartum period among Hispanic women in the United States. A total of 3952 Hispanic women who had delivered infants (parturients) were interviewed in postpartum wards in Miami, New York City and San Francisco. Symptoms of depression were regressed onto a series of social, psychological, and socioeconomic variables. Results showed that 42.6% of participants were probable cases of depression (CES-D > or = 16). Depression was negatively associated with perceived level of social support (adjusted OR = 0.59, 95% CI: 0.53-0.67) and health insurance coverage (adjusted OR = 0.68, 95% CI: 0.49-0.95), but not with the degree of acculturation or immigration status. It was found that depressive symptoms are common among Hispanic parturients. Pregnant Hispanic women should be carefully monitored for signs of depression and appropriate preventive measures are needed.     

公务员工作压力与抑郁症状之间的关系

目的探讨公务员工作压力和抑郁症状之间的关系。方法工作压力采用中文版的付出一获得不平衡量表，抑郁评价采用中文版CES—D量表。采用问卷形式对474名浙江省公务员进行横断面调查，调查内容包括工作付出、获得、超负荷，抑郁症状和一般情况。采用方差分析、秩和检验或X^2检验进行单因素分析，采用logistic回归进行多因素分析。使用Epidata2003建立数据库。采用SPSS13．0进行统计分析。结果本次调查结果显示浙江省公务员抑郁症状阳性率为41．56％（95％CI：39．30％～43．82％）。采用多元logistic回归校正了其他因素后，工作中付出一获得不平衡的0R=1．772（95％CI：0．369～8．508）。公务员抑郁症状与超负荷（OR=3．468，95％CI=1．542～7．801）、单身（OR=2．661，95％CI=1．017～6．963）、社会支持（0R=2．088，95％CI：1．246～3．498）和亚健康状态（0R=2．475，95％CI：1．110～5．520）有关。结论公务员工作超负荷对其健康状况有负面影响。     

A longitudinal study assessing depression in hepatitis C: Does gender play a role in the new-onset depression during interferon-alpha treatment?

In this prospective study conducted from October 2013 to June 2015 in Brighton, England, we examined differences between men and women in new-onset major depressive disorder (MDD) during interferon-alpha-based (IFN-α) therapy for hepatitis C virus (HCV). We included 155 HCV-infected patients (47 women), eligible to receive HCV therapy, including direct-acting antivirals. The Semi-Structured Clinical Interview was used to assess MDD. Severity of depressive symptoms was assessed using the Hamilton Depression Rating Scale. Patients were assessed at baseline, during treatment and 6 months after treatment completion. A significant increase in depressive symptoms was observed in the total sample from baseline to week 4, and a significant decrease was observed from end of treatment (week 24) to the sustained virological response (SVR) end point at 6 months posttreatment. Women were more likely to have a MDD at week 24. In both men and women, neurovegetative and mood-cognitive syndromes increased significantly at the early stage of treatment but remitted by the end of HCV therapy. Proportions with SVR were similar among females and males (91.5 percent vs. 87 percent). Under an inflammatory condition, boosted by interferon-based treatments, these results suggest that female gender is not associated with increased vulnerability for developing depression during IFN-α therapy.