DEPRESSED AFFECT, HOPELESSNESS, AND THE RISK OF ISCHEMIC-HEART-DISEASE IN A COHORT OF UNITED-STATES ADULTS
DEPRESSED AFFECT, HOPELESSNESS, AND THE RISK OF ISCHEMIC-HEART-DISEASE IN A COHORT OF UNITED-STATES ADULTS
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DOI：
10.1097/00001648-199307000-00003
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发表时间：
1993-07-01
期刊：
影响因子：
5.4
通讯作者：
MARKS, J
中科院分区：
文献类型：
--
作者：
ANDA, R;WILLIAMSON, D;MARKS, J
重度抑郁症与缺血性心脏病（IHD）的死亡率有关。此外，抑郁症的一种症状--绝望--被认为是健康状况的决定因素。我们研究了抑郁情绪和绝望与IHD发病率的关系，使用的数据来自2，832名年龄在45-77岁之间的美国成年人，他们参加了国家健康检查随访研究（平均随访= 12.4年），基线时没有IHD或严重疾病史。我们使用一般幸福感量表中的抑郁子量表来定义抑郁情绪，并使用量表中的一个项目来定义绝望。在基线时，11.1%的队列有抑郁情绪; 10.8%报告中度绝望，2.9%报告重度绝望。抑郁情绪和绝望情绪在女性、黑人和受教育程度较低、未婚、吸烟或不运动的人中更为常见。随访期间有189例致死性IHD病例。在我们调整人口统计学和危险因素后，抑郁情绪与致死性IHD相关[相对危险度= 1.5; 95%可信区间（CI）= 1.0-2.3];中度和重度绝望水平致死性IHD的相对危险度分别为1.6（95% CI = 1.0-2.5）和2.1（95% CI = 1.1-3.9）。抑郁情绪和绝望也与非致命性IHD的风险增加有关。这些数据表明，抑郁情绪和绝望可能在致命性和非致命性IHD的发生中发挥因果作用。
Major depression has been associated with mortality from ischemic heart disease (IHD). In addition, a symptom of depression-hopelessness-has been suggested as a determinant of health status. We studied the relation of both depressed affect and hopelessness to IHD incidence using data from a cohort of 2,832 U.S. adults age 45-77 years who participated in the National Health Examination Follow-up Study (mean follow-up = 12.4 years) and had no history of IHD or serious illness at baseline. We used the depression subscale of the General Well-Being Schedule to define depressed affect and a single item from the scale to define hopelessness. At baseline, 11.1% of the cohort had depressed affect; 10.8% reported moderate hopelessness, and 2.9% reported severe hopelessness. Depressed affect and hopelessness were more common among women, blacks and persons who were less educated, unmarried, smokers, or physically inactive. There were 189 cases of fatal IHD during the follow-up period. After we adjusted for demographic and risk factors, depressed affect was related to fatal IHD [relative risk = 1.5; 95% confidence interval (CI) = 1.0-2.3]; the relative risks of fatal IHD for moderate and severe levels of hopelessness were 1.6 (95% CI = 1.0-2.5) and 2.1 (95% CI = 1.1-3.9), respectively. Depressed affect and hopelessness were also associated with an increased risk of nonfatal IHD. These data indicate that depressed affect and hopelessness may play a causal role in the occurrence of both fatal and nonfatal IHD.