1990—2019年中国抑郁症发病趋势的Joinpoint回归与年龄-时期-队列分析

Joinpoint regression and age-period-cohort analysis of the incidence trends of depression in China from 1990 to 2019

目的 分析1990-2019年中国抑郁症的发病趋势及年龄、时期和队列效应产生的影响。方法 整理全球疾病负担研究2019(global burden of disease study 2019, GBD 2019)数据库中1990-2019年中国10~94岁人群抑郁症发病率数据,利用Joinpoint回归模型对抑郁症标化发病率的时间趋势进行分析;运用年龄-时期-队列模型分析抑郁症的年龄、时期和队列效应。结果 1990-2019年中国居民抑郁症的标化发病率总体呈下降趋势,女性高于男性,存在性别差异。Joinpoint回归模型显示,女性抑郁症标化发病率在1990-2019年平均每年下降0.64%[平均年度变化百分比(average annual percent change, AAPC)=-0.64%, P <0.001];男性抑郁症标化发病率在1990-2019年平均每年下降0.26%(AAPC=-0.26%,P=0.008)。年龄-时期-队列模型显示,抑郁症发病风险总体随年龄的增加而上升;随时期的推移变化趋势不明显;随队列的推移总体为下降趋势。结论 1990-2019年中国居民抑郁症的标化发病率总体呈下降趋势,应关注老年人群,制定卫生政策,以减轻社会负担及促进老年人群的心理健康。

Objective:To analyze the trends of depression in China from 1990 to 2019 and the impact resulting from age,period,and cohort effects.Methods:Data on the incidence rate of depression among Chinese aged 10~94 years from 1990 to 2019 in the Global Burden of Disease(GBD)Study 2019 database were collated to analyze the time trend of depression standardized incidence rate using Joinpoint regression model;Age-period-cohort models were used to analyze the age,period,and cohort effects of depression.Results:The standardized incidence rate of depression among Chinese residents showed a decreasing trend from 1990 to 2019,and was higher in women than in men,with a gender difference.Joinpoint regression models showed that the standardized incidence rate of depression among women decreased by an average of 0.64%per year from 1990 to 2019(AAPC=-0.64%,P<0.001);the male depression standardized incidence rate decreased by an average of 0.26%per year from 1990 to 2019(AAPC=-0.26%,P=0.008).Age-period-cohort models showed that the overall risk of depression increased with age;The trend of change with the increase of period was not significant;there was an overall decreasing trend with the increase of birth cohort.Conclusion:The standardized incidence rate of depression among Chinese residents shows a decreasing trend from 1990 to 2019,and the focus should be on the elderly population and health policies should be developed to reduce the social burden and promote the mental health of the elderly population.