全国社区老年人抑郁症知晓现状及影响因素

A cross-sectional survey on depression literacy and associated factors among community-dwelling older adults in China

目的 通过全国性调查,了解目前我国社区老年人群对老年抑郁症的知晓情况.方法 2014年6月20日至8月20日,采用方便抽样的方法,从全国20个省市自治区中34个城市选取3 439名社区老年人（≥60岁）进行调查.问卷包括精神卫生知晓率问卷和画钟测验（CDT）、老年期抑郁问卷（GDI）.结果 3 007名受试者（87.4％）完成问卷.老年抑郁症知识问卷8个条目中仅有2条的应答正确率超过50％.老年人群对老年抑郁症的知识总正确应答率为46.4％,高龄（x2=31.4,P=0.012）、工人农民（x2=46.5,P=0.004）、低文化水平（x2=74.2,P＜0.01）、非在婚状态（x2=29.1,P＜0.01）以及低收入人群（x2=38.75,P＜0.01）的正确应答率较低.受教育水平（小学：β=-0.055,95％ CI=-0.093～-0.017;中学：β=-0.032,95％ CI=-0.062～-0.001）和收入水平（低收入水平：β=-0.046,95％ CI=-0.066～-0.026）增高是总体知晓率升高的有利因素.结论 从全国范围看,老年人群对老年抑郁症的症状以及治疗与护理措施仍然认识不足,需要继续加强老年抑郁症的科普宣传教育,尤其是低教育水平和低收入人群.

Objective To investigate the depression literacy among older adults in China through a cross-sectional survey.Methods With convenience sampling methodology,3 439 adults older 60 were recruited from 34 communities in 20 cities and autonomous regions from June to August 2014.All participants completed the mental health literacy questionnaire,the clock drawing test （CDT） and the geriatric depression inventory （GDI） during face-to-face interview.Results 3 007 subjects （87.4%） completed all questionnaires.Only 2 of the 8 items in the geriatric depression literacy questionnaire had over 50% correct response rates.The global accuracy of the elderly depression was 46.4%.Lower global accuracy was more prevalent among older-old adults（x2=31.4,P=0.012）,workers and farmers（x2=46.5,P=0.004）,and those with lower education（x2 =74.2,P〈0.01）,without spouse （x2 =29.1,P〈 0.01） and lower income （x2 =38.75,P〈 0.01）.Global depression literacy was better with higher education level （elementary education vs college level：β=-0.055,95% CI=-0.093--0.017; middle schooling vs college level：β=-0.032,95% CI=-0.062--0.001） and income status （lower income vs high income：β=-0.046,95% CI=-0.066--0.026）.Conclusions The depression literacy on the symptoms,treatments and care among Chinese older adults is very low.Interventions may be best served by focusing on health education of depression among older adults,especially for those with lower education and income.