Risk factor modifications and depression incidence: a 4-year longitudinal Canadian cohort of the Montreal Catchment Area Study.
Risk factor modifications and depression incidence: a 4-year longitudinal Canadian cohort of the Montreal Catchment Area Study.
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DOI：
10.1136/bmjopen-2016-015156
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发表时间：
2017-06-10
期刊：
影响因子：
2.9
通讯作者：
Caron J
中科院分区：
文献类型：
--
作者：
Meng X;Brunet A;Turecki G;Liu A;D'Arcy C;Caron J
很少有研究研究改变危险因素对抑郁症发病率的影响。这项研究旨在探索抑郁症的心理社会危险因素，并在一项大规模的纵向人群研究中量化危险因素修改对抑郁症发病率的影响。数据来自蒙特利尔纵向集水区研究(N=2433)。采用多变量修正Poisson回归估计相对危险度(RR)。人群归因分数也被用来估计危险因素修改对抑郁症发病率的潜在影响。主要抑郁障碍的累积发生率在2年随访时为4.8%，在4年随访时为6.6%。年轻成年人、女性、丧偶、分居或离婚、高加索人、贫穷、偶尔饮酒、有精神健康问题家族病史、受教育程度较低、生活在失业率较高和少数族裔比例较高的地区、更多的文化社区中心和社区组织，始终与发生严重抑郁障碍的风险增加有关。虽然在2年的随访中只有5.1%的疾病发病率可能归因于偶尔饮酒(与戒酒者相比)，但在4年的随访中，偶尔饮酒的归因率翻了一番。在这一人群中，偶尔饮酒的流行率降低10%，可能会避免一半的事故病例。可改变的风险因素，无论是个人还是社会因素，都可以成为公共抑郁症预防方案的目标。这些方案还应针对不同的性别，因为已经确定了男女不同的风险因素。个人层面的公共卫生预防措施可以更好地管理偶尔饮酒，因为它解释了大约5%~10%的重大抑郁障碍事件。社区特征也可以成为公共预防方案的目标。然而，这可能是非常具有挑战性的。有必要对各种预防措施进行成本效益分析。
Few studies have examined the effect of risk factor modifications on depression incidence. This study was to explore psychosocial risk factors for depression and quantify the effect of risk factor modifications on depression incidence in a large-scale, longitudinal population-based study. Data were from the Montreal Longitudinal Catchment Area study (N=2433). Multivariate modified Poisson regression was used to estimate relative risk (RR). Population attributable fractions were also used to estimate the potential impact of risk factor modifications on depression incidence. The cumulative incidence rate of major depressive disorder at the 2-year follow-up was 4.8%, and 6.6% at the 4-year follow-up. Being a younger adult, female, widowed, separated or divorced, Caucasian, poor, occasional drinker, having a family history of mental health problems, having less education and living in areas with higher unemployment rates and higher proportions of visible minorities, more cultural community centres and community organisations, were consistently associated with the increased risk of incident major depressive disorder. Although only 5.1% of the disease incidence was potentially attributable to occasional drinking (vs abstainers) at the 2-year follow-up, the attribution of occasional drinking doubled at the 4-year follow-up. A 10% reduction in the prevalence of occasional drinking in this population could potentially prevent half of incident cases. Modifiable risk factors, both individual and societal, could be the targets for public depression prevention programmes. These programmes should also be gender-specific, as different risk factors have been identified for men and women. Public health preventions at individual levels could focus on the better management of occasional drinking, as it explained around 5%~10% of incident major depressive disorders. Neighbourhood characteristics could also be the target for public prevention programmes. However, this could be very challenging. A cost-effectiveness analysis of a variety of prevention efforts is warranted.
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影响因子：
12.7
作者：
Riolo, SA;Nguyen, TA;King, CA
通讯作者：
King, CA
影响因子：
6
作者：
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通讯作者：
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DOI：
10.1111/j.1530-0277.2006.00274.x
发表时间：
2007-01-01
影响因子：
3.2
作者：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
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DOI：
10.1177/070674371205700806
发表时间：
2012-08-01
影响因子：
4
作者：
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通讯作者：
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