The cross-sectional association of stressful life events with depression severity among patients with hypertension and diabetes in Malawi.
The cross-sectional association of stressful life events with depression severity among patients with hypertension and diabetes in Malawi.
复制标题
DOI：
10.1371/journal.pone.0279619
复制
发表时间：
2022
期刊：
影响因子：
3.7
通讯作者：
Zimba, Chifundo C.
中科院分区：
文献类型：
--
作者：
Landrum, Kelsey R.;Pence, Brian W.;Gaynes, Bradley N.;Dussault, Josee M.;Hosseinipour, Mina C.;Kulisewa, Kazione;Malava, Jullita Kenela;Masiye, Jones;Akello, Harriet;Udedi, Michael;Zimba, Chifundo C.
抑郁症是全球发病率的主要原因，在低收入和中等收入环境中仍然高得不成比例。应激生活事件(SLEs)是已知的抑郁发作和抑郁严重程度恶化的危险因素，但与其他抑郁危险因素相比，研究还不够深入。由于抑郁症通常与高血压、糖尿病和其他非传染性疾病(NCDs)并存，因此研究NCDs患者之间的这种关系对于增加抑郁症和NCD综合护理的机会特别相关。这项研究旨在评估在基线访谈前三个月中，至少有轻度抑郁症状的患者在马拉维的10家NCD诊所寻求NCD治疗的SLEs与基线抑郁严重程度之间的横向关联。SLEs由生活事件调查测量，抑郁的严重程度(轻度与中度到重度)由患者健康问卷-9测量。研究人群(n=708)目前主要是受过初等教育的经产妇女(5-8个孩子)。三分之二(63%)的人有轻度抑郁，而26%、8%和3%的人分别有中度、中度和重度抑郁。几乎所有参与者(94%)都报告至少最近发生过一次系统性红斑狼疮，其中最常见的报告是经济压力(48%)、关系变化(45%)、家人或朋友去世(41%)或家人或朋友患重病(39%)。离婚/分居、与家庭成员的疏远、失去收入来源以及新出现的重大健康问题是重度(中度或重度)抑郁严重程度比轻度严重程度的显著预测因素。有重大新的健康问题或经历离婚/分居会导致患更严重抑郁症的风险特别高。调整后，与轻度抑郁程度相比，每增加一次系统性红斑狼疮，中度或重度抑郁的风险增加9%(RR：1.09；(95%CI：1.05，1.13)，p<；0.0001)。在至少有轻度抑郁症状的非传染性疾病患者中，前3个月的SLEs与更严重的抑郁程度相关。虽然许多SLEs可能是不可预防的，但本研究表明，在经历SLEs时评估SLEs和教授积极的应对策略可能在NCD和抑郁症综合治疗模式中发挥重要作用。
Depressive disorders are a leading cause of global morbidity and remain disproportionately high in low- and middle-income settings. Stressful life events (SLEs) are known risk factors for depressive episodes and worsened depressive severity, yet are under-researched in comparison to other depression risk factors. As depression is often comorbid with hypertension, diabetes, and other noncommunicable diseases (NCDs), research into this relationship among patients with NCDs is particularly relevant to increasing opportunities for integrated depression and NCD care. This study aims to estimate the cross-sectional association between SLEs in the three months preceding baseline interviews and baseline depressive severity among patients with at least mild depressive symptoms who are seeking NCD care at 10 NCD clinics across Malawi. SLEs were measured by the Life Events Survey and depressive severity (mild vs. moderate to severe) was measured by the Patient Health Questionnaire-9. The study population (n = 708) was predominately currently employed, grand multiparous (5–8 children) women with a primary education level. Two thirds (63%) had mild depression while 26%, 8%, and 3% had moderate, moderately severe, and severe depression, respectively. Nearly all participants (94%) reported at least one recent SLE, with the most common reported SLEs being financial stress (48%), relationship changes (45%), death of a family member or friend (41%), or serious illness of a family member or friend (39%). Divorce/separation, estrangement from a family member, losing source of income, and major new health problems were significant predictors of greater (moderate or severe) depressive severity compared to mild severity. Having a major new health problem or experiencing divorce/separation resulted in particularly high risk of more severe depression. After adjustment, each additional SLE was associated with a 9% increased risk of moderate or worse depressive severity compared to mild depressive severity (RR: 1.09; (95% CI: 1.05, 1.13), p<0.0001). Among patients with NCDs with at least mild depressive symptoms, SLEs in the prior 3 months were associated with greater depressive severity. While many SLEs may not be preventable, this research suggests that assessment of SLEs and teaching of positive coping strategies when experiencing SLEs may play an important role in integrated NCD and depression treatment models.
登录
查看更多内容
影响因子：
7.4
作者：
Hammen, Constance;Kim, Eunice Y.;Eberhart, Nicole K.;Brennan, Patricia A.
通讯作者：
Brennan, Patricia A.
DOI：
10.1176/appi.ps.202000003
发表时间：
2021-07-01
期刊：
Psychiatric services (Washington, D.C.)
影响因子：
--
作者：
Gaynes BN;Akiba CF;Hosseinipour MC;Kulisewa K;Amberbir A;Udedi M;Zimba CC;Masiye JK;Crampin M;Amarreh I;Pence BW
通讯作者：
Pence BW
影响因子：
3.7
作者：
Lee JT;Hamid F;Pati S;Atun R;Millett C
通讯作者：
Millett C
影响因子：
5.9
作者：
Keller, Stephanie M.;Feeny, Norah C.;Zoellner, Lori A.
通讯作者：
Zoellner, Lori A.
DOI：
10.1016/s0140-6736(17)32152-9
发表时间：
2017-09-16
期刊：
Lancet (London, England)
影响因子：
--
作者：
GBD 2016 Causes of Death Collaborators
通讯作者：
GBD 2016 Causes of Death Collaborators