中国4省市社区空巢和非空巢老人抑郁症状及相关影响因素研究

Study on the prevalence and risk factors of depressive symptoms among ‘empty-nest＇ and‘non-empty-nest＇ elderly in four provinces and cities in China

目的了解城乡社区空巢与非空巢老人抑郁症现况并分析其影响因素及其差异。方法以整群抽样方法，调查4265名上海市、黑龙江省、广东省和山西省城乡社区〉160岁老年人，采用老年精神状况量表和白行研制的危险因素问卷开展人户调查，Mann-Whitneyu非参数检验和多元逐步非条件logistic回归的方法分析。结果（1）空巢老人抑郁症状检出率（8．18％）高于非空巢（6．31％），差异有统计学意义（P=0．019）；（2）空巢老人居住城市、男性、在婚、文化程度较高、收入水平较高（≥15000元／年）和有职业的比例较高（P〈0．0001）；（3）空巢老人健康和生活自评好的比例较高（P=0．0001，P〈0．0001），近两年健康出现明显变化和经济出现严重困难的比例较高（P=0．001，P=0．002）；（4）女性、独身、健康和生活白评差、躯体疾病≥3种、近两年发生健康明显改变和亲人去世、参加宗教和社区活动均是空巢老人患抑郁症状的影响因素；空巢老人抑郁症患病率存在地区差异。结论空巢老人出现抑郁症状的比例要高于非空巢老人。空巢老人具有独身、女性、近两年出现负性生活事件等特征，应是社区卫生工作重点关注的对象。

Objective To investigate the prevalence and determinants of depressive symptoms among ＇empty-nest＇ and ＇non-empty-nest＇ elderly in four cities/provinces. Methods 4265 elderly aged 60 and over, were recruited with cluster sampling method in Shanghai, Heilongjiang, Guangdong and Shanxi province and interviewed, using the Geriatric Mental State Schedule and self-developed related questionnaire. Results （ 1 ） The prevalence of depressive symptoms for ＇ empty-nest＇ elderly was （8.18%）, significantly higher than that for ＇non-empty-nest＇ elderly （P：0.019）; （2）the ＇empty-nest＇ elderly had a significantly higher proportion of the following factors： being male, married, with higher income （ ≥15 000 Yuan/year）, living in city, with high education background, under employment etc. than the ＇non-empty-nest＇ elderly （P〈0.0001） ; （3）the ＇empty-nest＇ elderly had significantly higher proportions on good self-rated health status and life （P=0,0001, P〈 0.0001 ） as well as heavier health problems and economic difficulties（P=0.001 ,P=0.002） ; （4）there were significantly negative associations between depressive symptoms and the following 10 factors： being female, single, having bad self-rated health and life status, having somatic disease ≥3, with big health problems in the last two years and loss of dearest persons, community engagement and involvement of religious activities. Conclusion The ＇ empty-nest＇ elderly showed higher prevalence of having depressive symptoms than the ＇non-empty-nest＇ elderly. The ＇empty-nest＇ elderly had characteristics as being single, female, having adverse event etc. and should be under greater attention for care.