绝经女性抑郁症状及其影响因素分析

Analysis of depression and its influencing factors in menopausal women

目的探讨绝经女性抑郁状况及其影响因素。方法通过横断面研究,采用问卷调查方式获取基本资料,应用抑郁自评量表(self-rating depression scale,SDS)进行抑郁症状评估,应用改良绝经症状量表(modified Kupperman index scale,KMI)进行绝经症状评估,采用SPSS20.0软件进行数据分析。结果共纳入1 591名女性,年龄中位数为52岁。KMI、SDS平均得分分别为13.9±8.8、39.6±9.0,绝经症状和抑郁症状发生率分别是77.7%、15.3%,围绝经期女性评分显著高于绝经后期女性评分,差异有统计学意义(P=0.027)。SDS评分在不同年龄段女性的差异较小(F=2.467,P>0.05)。经二分类多因素logistic回归分析校正混杂因素后显示KMI评分>6分(OR=1.148,95%CI=1.127~1.170)、生育3个以上子女(OR=1.339,95%CI=1.009~1.776)、受教育程度<9年(OR=1.768,95%CI=1.167~2.678)、癌症患病史(OR=2.685,95%CI=1.139~6.334)的绝经女性更容易出现抑郁症状。而经济收入>5 000元/月的女性则不容易出现抑郁症状(OR=0.597,95%CI=0.417~0.858)。结论围绝经期和绝经后期女性抑郁症状发生率较高。临床上应该采取更多措施改善绝经女性生活质量。

Objective To study the depression and its influencing factors in menopausal women. Methods A multicenter cross-sectional study was conducted to obtain basic data, self-rating depression scale（SDS） was used to evaluate depression and modified Kupperman index scale（KMI） was used to evaluate menopausal symptom. SPSS20.0 software was used for data analysis. Results A total of 1 591 women were enrolled, with a median age of 52 years old. The average scores of KMI and SDS were 13.9±8.8 and 39.6±9.0, respectively. The prevalences were 77.7% and 15.3%, respectively. The scores of perimenopausal women were significantly higher than those of postmenopausal women（P=0.027）. There was no significant difference about SDS score among women of different ages（40-60 years old）（F=2.467, P〉0.05）. After adjusting for confounding factors by logistic stepwise regression with binary classification, we found that having children more than three（OR=1.198, 95% CI=1.098-1.425）, KMI score〉 6（OR=1.153, 95% CI=1.131-1.175）, a history of cancer（OR=3.092, 95% CI=1.221-7.828） were risk factors for depressive symptoms. Women with economic income 〉 5 000 yuan/month were less prone to depressive symptoms（OR=0.344, 95% CI=0.172-0.689）. Conclusion The incidence of depression in perimenopausal and postmenopausal women is higher. More clinical measures should be taken to improve the quality of life of postmenopausal women.