Chronic conditions and major depression in community-dwelling older adults
Chronic conditions and major depression in community-dwelling older adults
复制标题
DOI：
10.1016/j.jad.2010.11.028
复制
发表时间：
2011-06-01
影响因子：
6.6
通讯作者：
Wang, JianLi
中科院分区：
文献类型：
--
作者：
Fiest, Kirsten M.;Currie, Shawn R.;Wang, JianLi
目的：估计（1）长期医疗条件和共病重性抑郁症的患病率，以及（2）在老年人的一般人群中重性抑郁症和各种慢性医疗条件之间的关联（50岁以上）和传统上被归类为老年人的人方法：分析加拿大社区健康调查-心理健康和幸福感（CCHS-1.2）的数据。加拿大10个省15岁以上的非机构化个人在CCHS-1.2中进行了抽样调查。CCHS-1.2的整个样本由36，894人组成，对于本研究的主要分析，数据集仅限于50岁及以上的人。（n = 15 591）。使用医生诊断的自我报告方法评估慢性健康状况。世界精神健康复合诊断访谈被用来评估基于DSM-IV criteria.Results的主要抑郁发作：有至少一种慢性疾病的总体患病率在那些超过50岁的是82.4%，相比之下，62.0%在那些50岁以下。50岁以上有一种慢性疾病的人中，重度抑郁发作的患病率为3.7%，而没有长期医疗条件的人中，这一比例为1.0%。65岁或以上老年人的前三大慢性健康状况是关节炎/风湿病，高血压和背部问题。慢性疲劳综合征、纤维肌痛和偏头痛在老年人群中与重度抑郁症的共病率最高。局限性：慢性健康状况的自我报告数据的使用，疾病之间潜在的诊断重叠，以及由于数据的横截面性质而无法进行因果推断，这些都是本研究的局限性。结论：在这项研究中，普通人群、老年人和老年人之间的慢性病和重度抑郁症的发病率存在差异。需要进一步的研究来描绘老年人这些关系的方向。一级和二级预防工作应针对表现出抑郁症状或高度流行的慢性健康状况的老年人。(C)2010 Elsevier B. V.保留所有权利。
Objectives: To estimate (1) the prevalence of long-term medical conditions and of comorbid major depression, and (2) the associations between major depression and various chronic medical conditions in a general population of older adults (over 50 years of age) and in persons who are traditionally classified as seniors (65 years and older).Methods: Data from the Canadian Community Health Survey- Mental Health and Wellbeing (CCHS-1.2) were analyzed. Non-institutionalized individuals over 15 years of age in the 10 Canadian provinces were sampled in the CCHS-1.2. The entire sample of the CCHS-1.2 consisted of 36,894 individuals, for the main analyses in this study the dataset was restricted to those aged 50 and over.(n = 15,591). Chronic health conditions were assessed using a self-report method of doctor diagnosis. The World Mental Health-Composite Diagnostic Interview was used to asses major depressive episodes based on DSM-IV criteria.Results: The overall prevalence of having at least one chronic condition in those over 50 years of age was 82.4%, compared to 62.0% in those under 50. The prevalence of a major depressive episode in those over 50 with one chronic condition was 3.7%, compared with 1.0% in those without a long-term medical condition. The top 3 chronic health conditions in seniors aged 65 or older were arthritis/rheumatism, high blood pressure and back problems. Chronic Fatigue Syndrome, fibromyalgia and migraine headache had the highest comorbidity with major depression in the senior population.Limitations: The use of self-report data on chronic health conditions, potential diagnostic overlap between conditions, and the inability to make causal inferences due to the cross-sectional nature of the data are all limitations of the current study.Conclusions: Differences were found between rates of chronic conditions and major depression between the general population, older adults and seniors in this study. Further research is needed to delineate the direction of these relationships in seniors. Primary and secondary prevention efforts should target seniors who exhibit symptoms of depression or highly prevalent chronic health conditions. (C) 2010 Elsevier B.V. All rights reserved.