Prevalence of depression: Comparisons of different depression definitions in population-based samples of older adults
Prevalence of depression: Comparisons of different depression definitions in population-based samples of older adults
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DOI：
10.1016/j.jad.2017.06.011
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发表时间：
2017-10-15
影响因子：
6.6
通讯作者：
Wang, Hui-Xin
中科院分区：
文献类型：
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作者：
Sjoberg, Linnea;Karlsson, Bjorn;Wang, Hui-Xin
背景：老年人的抑郁症患病率在不同的研究中差异很大，这可能反映了方法上的差异，而不是真正的差异。本研究旨在探讨在不同的诊断标准和评分量表以及不同的老年人样本中，抑郁症的患病率是否以及在多大程度上发生了变化。方法：从2001-2004年瑞典国家Kungsholmen老龄化与护理研究（SNAC-K）中抽取3353名年龄在60-104岁之间的人群样本进行研究。通过以下方法估计抑郁症的点患病率：1)诊断标准，ICD-10和DSM-IV-TR/DSM-5；2)评定量表，MADRS和GDS-15；3)自我报告。按痴呆状态、居住地点和社会人口统计学对亚样本的抑郁症患病率进行比较。结果：ICD-10的抑郁症患病率（包括所有严重等级）为4.2%（中度/重度：1.6%），DSM-IV-TR的抑郁症患病率为9.3%（重度：2.1%）；MADRS为10.6%，GDS-15为9.2%；自我报告占9.1%。与总人口相比，无痴呆样本中抑郁症患病率较低。此外，在大多数抑郁症定义中，身体机能差或没有伴侣与更高的抑郁症患病率独立相关。局限性：应答率为73.3%，这可能导致对抑郁症的低估。结论：除ICD-10外，所有抑郁症定义的抑郁症患病率相似，显示的数据要低得多。然而，与所使用的定义无关，抑郁症的患病率因痴呆状态、身体功能和婚姻状况而有很大差异。这些发现可能对临床医生评估老年人抑郁症和研究人员探索和比较研究中抑郁症的患病率有用。
Background: Depression prevalence in older adults varies largely across studies, which probably reflects methodological rather than true differences. This study aims to explore whether and to what extent the prevalence of depression varies when using different diagnostic criteria and rating scales, and various samples of older adults.Methods: A population-based sample of 3353 individuals aged 60-104 years from the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K) were examined in 2001-2004. Point prevalence of depression was estimated by: 1) diagnostic criteria, ICD-10 and DSM-IV-TR/DSM-5; 2) rating scales, MADRS and GDS-15; and 3) self-report. Depression prevalence in sub-samples by dementia status, living place, and socio-demographics were compared.Results: The prevalence of any depression (including all severity grades) was 4.2% (moderate/severe: 1.6%) for ICD-10 and 9.3% (major: 2.1%) for DSM-IV-TR; 10.6% for MADRS and 9.2% for GDS-15; and 9.1% for selfreport. Depression prevalence was lower in the dementia-free sample as compared to the total population. Furthermore, having poor physical function, or not having a partner were independently associated with higher depression prevalence, across most of the depression definitions.Limitations: The response rate was 73.3% and this may have resulted in an underestimation of depression.Conclusion: Depression prevalence was similar across all depression definitions except for ICD-10, showing much lower figures. However, independent of the definition used, depression prevalence varies greatly by dementia status, physical functioning, and marital status. These findings may be useful for clinicians when assessing depression in older adults and for researchers when exploring and comparing depression prevalence across studies.