Excess mortality in depression: a meta-analysis of community studies
Excess mortality in depression: a meta-analysis of community studies
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DOI：
10.1016/s0165-0327(01)00413-x
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发表时间：
2002-12-01
影响因子：
6.6
通讯作者：
Smit, H
中科院分区：
文献类型：
--
作者：
Cuijpers, P;Smit, H
背景资料：虽然大多数研究抑郁症和死亡率之间的关系表明，抑郁症患者的死亡率过高，但并非所有研究都证实了这一点。此外，据推测，抑郁症男性的死亡率高于抑郁症女性。最后，尚不清楚死亡率的增加是否仅存在于重度抑郁症或亚临床抑郁症中。方法：对这些问题进行荟萃分析。共有25项研究，涉及106，628名受试者，其中6416人患有抑郁症。进行单变量和多变量分析。结果：抑郁症患者死亡的总体相对危险度（RR）为1.81（95%CI：1.58-2.07）。男女之间没有发现重大差异，尽管男性的RR稍大。亚临床抑郁症的RR不小于临床抑郁症的RR。局限性：仅检查了死亡率的RR，未对重要的混杂变量（如慢性疾病或生活方式）进行校正。在选定的研究中，研究特征和人群之间存在重要差异。比较的次数相对较少。结论：抑郁症的死亡风险增加。这项研究的一个重要发现是，增加的风险不仅存在于重性抑郁症中，而且存在于亚临床形式的抑郁症中。在许多情况下，抑郁症应被视为一种危及生命的疾病。(C)2002 Elsevier Science B. V.保留所有权利。
Background: Although most studies examining the relationship between depression and mortality indicate that there is excess mortality in depressed subjects, this is not confirmed in all studies. Furthermore, it has been hypothesized that mortality rates in depressed men are higher than in depressed women. Finally, it is not clear if the increased mortality rates exist only in major depression or also in subclinical depression. Methods: A meta-analysis was conducted to examine these questions. A total of 25 studies with 106,628 subjects, of whom 6416 were depressed, were examined. Both univariate and multivariate analyses were conducted. Results: The overall relative risk (RR) of dying in depressed subjects was 1.81 (95% Cl: 1.58-2.07) compared to non-depressed subjects. No major differences were found between men and women, although the RR was somewhat larger in men. The RR in subclinical depression was no smaller than the RR in clinical depression. Limitations: Only RRs of mortality were examined, which were not corrected for important confounding variables, such as chronic illnesses, or life-style. In the selected studies important differences existed between study characteristics and populations. The number of comparisons was relatively small. Conclusions: There is an increased risk of mortality in depression. An important finding of this study is that the increased risk not only exists in major depression, but also in subclinical forms of depression. In many cases, depression should be considered as a life-threatening disorder. (C) 2002 Elsevier Science B.V. All rights reserved.