中国男男性行为者抑郁患病率Meta分析

Prevalence of depression among men who have sex with men in China:a meta-analysis

目的通过Meta分析了解我国男男性行为者(MSM)抑郁患病情况,为早期心理干预提供科学依据。方法检索国内外相关文献,采用STROBE声明中横断面研究评价标准进行文献质量评价,利用Stata 12.0软件合并患病率,并对艾滋病病毒(HIV)感染情况、诊断标准、调查年代、抽样方法等因素进行亚组分析,采用Egger检验评估各文献发表偏倚,通过使用不同模型和排除其中任意一篇文献对合并效应值的影响进行敏感性分析。结果共纳入31篇文献,总样本量10629人,中国MSM抑郁患病率为43.9%[95%可信区间(CI):36.9%~48.8%]。对抑郁患病率情况进行亚组分析,高收入地区(44.9%,95%CI:35.1%~54.7%)的抑郁症患病率高于中低收入地区(43.1%,95%CI:37.4%~48.1%);采用SDS诊断标准的抑郁患病率(45.2%,95%CI:33.4%~57.1%)高于CES-D的患病率(43.9%,95%CI:37.9%~49.8%);HIV阳性MSM(50.1%,95%CI:34.5%~65.8%)的抑郁患病率高于HIV阴性/无报告MSM(41.7%,95%CI:36.8%~46.7%),差异均有统计学意义(P<0.05)。调查时间及抽样方法的不同对MSM中抑郁患病率造成的差异无统计学意义(P>0.05)。结论针对我国MSM抑郁情况,应采取适当的干预方法,及早进行干预,改善MSM抑郁状况。

Objective To understand the prevalence of depression among men who have sex with man(MSM)and provide scientific basis for early intervention through meta analysis.Methods The related literature at home and abroad were searched.The quality of articles was evaluated based on the cross-sectional study criteria according to STROBE statement.We used Stata 12.0 software to combine prevalence,and do subgroup analysis of HIV infection,diagnostic criteria,survey years,sampling methods and other factors.Egger testing was used to evaluate the publication bias of these articles.We did sensitivity analysis by using different models and eliminating any one of the included articles to evaluate the influence of combined effect value.Results 31 articles were included.The total sample size was 10629.The prevalence of depression among MSM in China was 43.9%(95%CI:36.9%-48.8%).The subgroup analyses showed that the prevalence of depression in high-income areas(44.9%,95%confidence interval:35.1%-54.7%)was higher than that in low-and middle-income areas(43.1%,95%confidence interval:37.4%-48.1%).The prevalence of depression using SDS diagnostic criteria(45.2%,95%confidence interval:33.4%-57.1%)was higher than that of CES-D(43.9%,95%confidence interval:37.9%-49.8%).The prevalence of depression in HIV positive MSM(50.1%,95%confidence interval:34.5%-65.8%)was higher than that in HIV negative/unreported MSM(41.7%,95%confidence interval:36.8%-46.7%).The differences were statistically significant(P<0.05).There was no significant difference in the prevalence rate of depression among MSM caused by different investigation time and sampling methods(P>0.05).Conclusion According to the depression status of MSM in China,appropriate intervention methods and early intervention should be adopted to improve the psychological state of MSM.