社区老年人心脑血管疾病共病抑郁障碍流行病学特征及其影响因素分析

Epidemiology characteristics and its influence factor analysis in community elderly patients with cardiac cerebral and vascular diseases comorbid depressive disorder

目的调查社区老年人心脑血管疾病患者共病抑郁障碍的现况及易感因素,为社区疾病防治提供重要依据。方法随机抽取浦东新区15个街镇在册常住老年人共调查3311名,将患有明显心脑血管疾病的574名老年人进行抑郁障碍共病调查(疾病组),574名无明显躯体和精神疾病者作对照(健康组)。调查工具包括自编"一般状况调查问卷"及"美国精神障碍诊断与统计手册第4版(DSM-Ⅳ)轴Ⅰ障碍定式临床检查患者版(SCID-I/P)",进行多因素Logistic回归分析。结果疾病组中164例共病抑郁障碍(28.6%),高于健康组(17.1%)(χ2=21.54,P<0.01);Logistic回归分析发现,高龄、女性、家庭经济困难、家庭关系不良是共病抑郁障碍的独立相关风险因素。结论老年心脑血管疾病患者共病抑郁障碍患病率高于健康老年人群,对易感因素采取积极有效的干预方法可降低患病率,有利于提高老年人生活质量。

Objective To investigate the status of comorbid depressive disorders and its risk factor in community elderly patients with Cardiac Cerebral And Vascular Diseases(CCVD),to provide important basis for disease prevention and control in community.Methods 3311 registered permanent old man were surveyed in random pudong new area 15 street town,574 old men with obvious CCVD were used for depressive disorder comorbidity survey(disease),and 574 old men had no obvious physical and mental illness as a control(the healthy group).Survey tools including wrote 'general condition investigation questionnaire' and 'the diagnostic and statistical manual of mental disorders(DSM-Ⅳ)axis I obstacles clinical examination by patients version(SCID-I/P)'.Multi-factors Logistic regression analysis were used.Results 164 cases in disease group comorbid depressive disorder(28.6%),higher than the health group(17.1%)(χ2=21.54,P<0.01);Logistic regression analysis found that older age,women,family economic difficulties,family relationship bad were the independently associated risk factors of depressive disorders.Conclusions The elderly CCVD patients have a higher rates of comorbidity depression than the healthy elderly population,take effective intervention methods can reduce the prevalence and help to improve the quality of life in the old men.