高原之上的忧郁: 海拔高度与抑郁风险的关系

Depression above the plateau: The relationship between altitude and depression risk

为揭示海拔高度与人群抑郁间的关系,研究运用2016~2020中国家庭追踪调查、2015中国健康与养老追踪调查、2016青海玉树成年人身心健康状况调查、《中国城市统计年鉴》等数据,采用多层线性模型、中介模型与流行病学病例对照等方法进行数据分析。结果表明:在控制个体与地区层面因素后,海拔高度与抑郁存在正相关关系;人均GDP与C反应蛋白在海拔高度与抑郁之间发挥中介作用;生活在海拔500~1000、1000~2000及4000~6000米的人群,其抑郁风险分别是生活在500米以下海拔人群的1.53~1.79倍、1.67~2.25倍与9倍左右;生活在500~2000米海拔地区中老年人抑郁风险高于青年人,4000~6000米高海拔地区青年人抑郁风险高于中老年人。综上,研究提示海拔高度是抑郁的危险因素,需高度关注不同海拔地区不同年龄人群的抑郁防范工作。

Research on the connection between altitude and depression in China remains scarce,despite the country’s extensive plateau regions.While the impact of altitude on physical health is well documented,existing studies have largely focused on social adaptation or physical well-being,leaving the relationship between altitude and depression underexplored.This study addresses this gap by examining how altitude affects depression among Chinese residents.Data were drawn from various sources,including the 2016~2020 China Family Panel Studies,the 2015 China Health and Retirement Longitudinal Study,the 2016 survey on physical and mental health in Yushu,and statistics from the China Urban Statistical Yearbook and China Statistical Yearbook.The study involved the use of several statistical techniques,including multilevel linear models,mediation models,and epidemiological case‒control methods.The results revealed a significant positive association between altitude and depression,even when personal factors such as age,sex,education,and chronic illness were controlled for,along with regional factors such as temperature,PM 2.5 concentration,per capita GDP,and hospital bed availability.Notably,per capita GDP and C-reactive protein levels were found to mediate this relationship.The risk of depression in individuals living at altitudes of 500~1000 metres,1000~2000 metres,and 4000~6000 metres was 1.53~1.79 times,1.67~2.25 times,and 9 times greater,respectively,than the risk in for individuals living below 500 metres.The study also revealed age-specific variations in the risk of depression.Middle-aged and elderly individuals living at altitudes between 500~2000 metres are more vulnerable to depression than younger individuals are.In contrast,young people residing at altitudes of 4000~6000 metres face a greater risk of depression than their older counterparts do.These findings highlight the diverse impacts of altitude on the risk of depression across different age groups.In conclusion,this study highlights altitude as a significant risk factor affecting depression among Chinese residents,which suggests the need for targeted mental health interventions that consider both age and altitude.It also challenges the traditional view of age and mental health,suggesting that both individual and environmental factors should be considered in mental health prevention and intervention strategies.