The prevalence and correlates of major and minor depression in older medical inpatients
The prevalence and correlates of major and minor depression in older medical inpatients
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DOI：
10.1111/j.1532-5415.2005.53404.x
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发表时间：
2005-08-01
影响因子：
6.3
通讯作者：
Elie, M
中科院分区：
文献类型：
--
作者：
McCusker, J;Cole, M;Elie, M
目的：描述老年内科住院患者中重度和轻度抑郁症的患病率和相关特征，并通过性别和抑郁症史比较相关特征。设计：对两个患者样本进行横断面研究，有和没有重度或轻度抑郁症的筛查诊断。65岁及以上最多有轻度认知障碍的人的医疗入院（N=380）。抑郁症的诊断（诊断访谈时间表），认知障碍（简易精神状态检查），病前残疾，社会人口学变量（包括社交网络和支持）、合并症、疾病严重程度、抑郁史。各医院的重度抑郁症患病率不同，范围从A医院的14.2%（95%置信区间（CI）=11.7-17.1）到B医院的44.5%（95% CI=33.1-56.4）。两所医院的轻度抑郁症患病率相似，范围从A医院的9.4%（95% CI=7.4-11.9）到B医院的7.9%（95% CI=2.9-16.3）。在调整住院因素后，相同的特征（抑郁症史、病前残疾、认知障碍、感知的支持充分性和朋友的来访）与重度和轻度抑郁症相关，尽管大多数这些相关性倾向于弱于轻度抑郁症。在多变量分析中，这些因素中的大多数也与抑郁症有关。女性最重要的特征是病前残疾、抑郁症史和情感支持充足;男性则是抑郁症史、认知障碍和情感支持充足。脑血管或其他心血管疾病的诊断并没有解释抑郁症和认知功能障碍之间的关联。结论：严重和轻微的抑郁症经常发生在老年内科住院患者，并与类似的患者特征。在识别和解释这些相关因素时，应考虑抑郁症史和患者的性别。
OBJECTIVES: To describe the prevalence of and characteristics associated with major and minor depression in older medical inpatients and to compare associated characteristics by sex and history of depression.DESIGN: Cross-sectional study of two patient samples, with and without a screening diagnosis of major or minor depression.SETTING: The medical services of two acute care hospitals.PARTICIPANTS: Medical admissions of people aged 65 and older with at most mild cognitive impairment (N=380).MEASUREMENTS: Diagnoses of major and minor depression (Diagnostic Interview Schedule), cognitive impairment (Mini-Mental State Examination), premorbid disability, sociodemographic variables (including social networks and support), comorbidity, severity of illness, history of depression.RESULTS: The prevalence of major depression differed by hospital, ranging from 14.2% (95% confidence interval (CI)=11.7-17.1) in Hospital A to 44.5% (95% CI=33.1-56.4) in Hospital B. The prevalence of minor depression was similar in the two hospitals, ranging from 9.4% (95% CI=7.4-11.9) in Hospital A to 7.9% (95% CI=2.9-16.3) in Hospital B. After adjustment for hospital, the same characteristics (history of depression, premorbid disability, cognitive impairment, perceived adequacy of support, and visits from friends) were associated with major and minor depression, although most of these associations tended to be weaker for minor depression. Most of these factors were also associated with depression in multivariate analyses. The most important characteristics in women were premorbid disability, history of depression, and adequacy of emotional support; in men they were history of depression, cognitive impairment, and adequacy of emotional support. A cerebrovascular or other cardiovascular diagnosis did not explain the association between depression and cognitive impairment.CONCLUSION: Major and minor depression occur frequently in older medical inpatients and are associated with similar patient characteristics. A history of depression and the patient's sex should be considered in the identification and interpretation of these associated factors.