上海浦东新区慢性躯体疾病老年人共病抑郁障碍调查

The investigation of depression in the elderly comorbided with chronic somatic disorders in the community of Pudong new area

目的:对上海市浦东新区慢性躯体疾病老年人共病抑郁障碍的患病率及其易感因素进行调查。方法:随机抽取浦东新区常住≥60岁老人3311名,对确诊患有慢性躯体疾病的1860例老人应用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)作为诊断工具进行调查。结果:1860例老人中抑郁障碍时点患病率为10.91%(203例),其中恶劣心境119例(6.40%),重性抑郁发作84例(4.51%),男∶女=1∶1.05。共病抑郁障碍的患病率以高龄、独居、文化程度较高、家庭关系和邻里关系紧张、经济困难以及多种躯体疾病者为高(P均<0.01)。Logistic回归分析显示,高龄、独居、文化程度高、家庭关系紧张、多种躯体疾病是共病抑郁障碍的独立相关风险因素(P<0.05或P<0.01)。结论:上海市浦东新区慢性躯体疾病老年人随着疾病增多,共病抑郁障碍增加。

Objective： To carry out an investigation of the prevalence and risk factors of depression in the elderly who comorbided with chronic somatic disorders in the community of Pudong new area. Method：A survey was performed among 3 311 elderly residents （ t〉60 years） who were randomly selected from 43 villages （neighborhood） committees. And 1 860 paricipants who comorbided with chronic somatic disorders were applied with the United States diagnostic and statistical manual of mental disorders 4th edition （ DSM-1V ） axis I disor- ders-style version of the clinical examination of patients （SCID-I/P） diagnostic tool. Results.The point prev- alence of depression was 10.91% （203 cases）, mostly was dysthymia 6.40% （ 119 cases）, then major depres- sion disorder 4.51% （ 84 cases）. The ratio of male to female was 1 ： 1.05. The higher prevalence of depression Was associated with aging, higher education, less family support, living alone, and the number of somatic disor- ders （ all P 〈 0.01 ）. Logistic regression analysis also showed that aging, living alone, higher education, less fam- ily support,comorbided with somatic disorders,were all independent risk factors associated with depression （P 〈 0.05 or P 〈 0.01 ）. Conclusion： The prevalence of depression in elderly was increased with the number of chronic somatic disorders.