Psychosocial and sociodemographic predictors of attrition in a longitudinal study of major depression in primary care: the predictD-Spain study
Psychosocial and sociodemographic predictors of attrition in a longitudinal study of major depression in primary care: the predictD-Spain study
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DOI：
10.1136/jech.2008.085290
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发表时间：
2010-10-01
影响因子：
6.3
通讯作者：
Torres-Gonzalez, Francisco
中科院分区：
文献类型：
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作者：
Angel Bellon, Juan;de Dios Luna, Juan;Torres-Gonzalez, Francisco
背景在纵向调查中，很少有与磨耗相关的心理社会因素的数据。本研究旨在通过对初级保健中重度抑郁症发作和持续的纵向研究，确定心理社会和社会人口学因素对磨耗的预测作用。方法从2005年10月至2006年2月，在西班牙7个省系统随机抽取了全科医生。使用综合国际诊断访谈诊断重度抑郁症，并在基线和6个月和12个月的随访后评估一组39个个体和环境因素对抑郁症的影响。结果筛选出年龄18~75岁的初级保健就诊者7777人，排除1251人(16.1%)。在其余6526人中，1084人(16.6%)拒绝参加。因此，5442名患者(41个健康中心的231名家庭医生)接受了基线访谈，其中3804名(70%)和3567名(66%)分别进行了6个月和12个月的随访。与心理社会因素相比，省籍和社会人口学因素是更强的磨损预测因素。抑郁和焦虑没有影响，但其他心理社会因素影响了磨耗。当包括基线和6个月时测量的预测因素时，12个月丢失的患者有不同的概况。结论这些发现表明，一些心理社会因素可能被认为是初级保健队列中的损耗因素，并证实了在纵向研究中，基线特征不足以分析无反应，表明对于6个月和12个月受访的患者，应采用不同的保留策略。
Background Few data exist on the psychosocial factors associated with attrition in longitudinal surveys. This study was undertaken to determine psychosocial and sociodemographic predictors of attrition from a longitudinal study of the onset and persistence of episodes of major depression in primary care.Methods A systematic random sample of general practice attendees was recruited in seven Spanish provinces between October 2005 and February 2006. Major depression was diagnosed using the Composite International Diagnostic Interview and a set of 39 individual and environmental risk factors for depression were assessed at baseline and after 6 and 12 months of follow-up. Data were analysed using multilevel logistic regression.Results 7777 primary care attendees aged 18-75 years were selected, of whom 1251 (16.1%) were excluded. Of the remaining 6526, 1084 (16.6%) refused to participate. Thus, 5442 patients (attending 231 family physicians in 41 health centres) were interviewed at baseline, of whom 3804 (70%) and 3567 (66%) remained at 6 and 12 months of follow-up, respectively. The province and sociodemographic factors were stronger predictors of attrition than psychosocial factors. Depression and anxiety had no effect but other psychosocial factors affected attrition. There were different profiles for the patients lost at 12 months when predictors measured at baseline versus 6 months were included.Conclusions These findings suggest that several psychosocial factors might be considered factors of attrition in primary care cohorts and confirm that baseline characteristics are insufficient for analysing non-response in longitudinal studies, indicating that different retention strategies should be applied for patients interviewed at 6 and 12 months.