社区老年人群抑郁障碍的影响因素  

Influential Factors of Depressive Disorder among Older Adults in the Community

作　　者：刘凯[1] 陈英[1] 周晓莉[1] 江帆[1] 韩坤元[1] 朱材忠[1] 仝珊[1] Liu Kai;Chen Ying;Zhou Xiaoli;Jiang Fan;Han Kunyuan;Zhu Caizhong;Tong Shan(Hainan General Hospital,Haikou 570311)

机构地区：[1]海南省人民医院,海口570311

出　　处：《国际老年医学杂志》2022年第2期141-144,210,共5页International Journal of Geriatrics

基　　金：2019年度海南省卫生计生行业科研项目(19A200026)。

摘　　要：目的探讨社区老年人群发生抑郁障碍的危险和保护因素。方法采用横断面调查设计,对2620例60岁以上的老年人进行抽样分析。使用社会人口统计调查问卷、简易日常生活挑战应对(COPE)量表和老年抑郁量表(GDS)调查问卷进行评估并收集数据。结果2620例老年人中,抑郁障碍99例,患病率为3.78%。在99例抑郁障碍的人群中,不同年龄、居住状态、宗教信仰、慢性病患病情况的老年人抑郁障碍发生率比较,差异均有统计学意义(P<0.05);而不同性别、文化程度、生活状态、收入状况的老年人抑郁障碍发生率比较,差异均无统计学意义(P>0.05)。有抑郁障碍组的积极应对、计划、幽默的使用率较无抑郁障碍组低,行为脱离和接受的使用率高于无抑郁障碍组,差异均有统计学意义(P<0.05)。多因素logistic回归分析结果发现:年龄≥75岁、离婚/分居、丧偶、有慢性病和行为脱离是社区老年人群抑郁障碍发生的独立危险因素(P<0.05),有宗教信仰、积极应对的应对方式是社区老年人群抑郁障碍发生的保护因素(P<0.05)。结论重视社区居住的年龄≥75岁、离婚/分居、丧偶、有慢性病以及行为脱离的应对方式的老年人群,可能是抑郁障碍的高发人群,需加强社区的心理干预和管理。Objective To investigate the risk and protective factors for depressive disorder in older adults in the community.Methods A cross-sectional survey was conducted in 2 620 older persons>60 years. Sociodemographic questionnaire, brief challenging outdoor personal experience(COPE) scale, and the geriatric depression scale(GDS) were used to assess and collect the data.Results Among the 2 620 older persons, 99 cases suffered from depressive disorder, with a prevalence rate of 3.78%.The prevalenc of depressive disorder varied with age, living status, religious belief, and chronic disease in older people living in the community(P<0.05).However, it did not change with gender, educational level, living conditions and income(P>0.05).In people with depressive disorder, the use rates of positive coping, planning and humor were lower than those in people without depressive disorder, and the use rates of behavioral disengagement and acceptance were higher(P<0.05).Multivariate logistic regression analysis showed that age≥75 years old, divorced/separated, widowed, chronic diseases and behavioral disengagement were independent risk factors for depressive disorder in older population living in the community(P<0.05).The religious belief and positive coping were protective factors(P<0.05).Conclusion Older people aged≥75 years, divorced/separated, widowed, with chronic diseases and behavioral disengagement may be at risk of depressive disorder, and community psychological intervention and management should be performed.

关 键 词：社区 老年 抑郁障碍 患病率 应对策略 

分 类 号：R749.4[医药卫生—神经病学与精神病学]