抑郁症急性期受试者队列研究失访的影响因素  

Influencing factors of loss of follow-up in a cohort study of participants with acute phase depressive disorders

作　　者：刘静 朱雪泉[1] 周晶晶[1] 王巍巍[1] Liu Jing;Zhu Xuequan;Zhou Jingjing;Wang Weiwei(Beijing Key Laboratory of Mental Disorders,National Clinical Research Center for Mental Disorders&National Center for Mental Disorders,Beijing Anding Hospital,Capital Medical University,Beijing 100088,China)

机构地区：[1]首都医科大学附属北京安定医院,国家精神疾病医学中心,国家精神心理疾病临床医学研究中心,精神疾病诊断与治疗北京市重点实验室,北京100088

出　　处：《中华行为医学与脑科学杂志》2024年第5期464-469,共6页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：北京市卫生健康委员会首都卫生发展专项(首发2022-4-2125);北京市教育委员会科研计划一般项目(KM202210025008);北京市科学技术委员会首都临床特色诊疗技术研究及转化应用(Z221100007422010)。

摘　　要：目的:探究临床队列研究中,抑郁症急性期受试者失访的影响因素。方法:2017—2021年,采用多中心前瞻性队列研究,对抑郁症急性期受试者在基线、4周末和8周末进行随访,采集受试者的一般情况、疾病特征、生活满意度、功能状态等信息。根据患者是否按照随访计划进行现场访视确定是否失访,采用SAS 9.4软件进行数据描述和统计分析,采用多因素Logistic回归分析探究受试者失访的影响因素。结果:共纳入1023名急性期抑郁症患者作为研究对象,17项汉密尔顿抑郁量表得分为(18.3±6.6)分,简明幸福与生活质量满意度问卷得分为(37.7±9.6)分,席汉残疾量表得分为(13.8±7.5)分。4周末、8周末失访率和完全失访率分别为28.6%(293/1023),19.5%(199/1023)和13.9%(142/1023)。多因素分析结果显示,受试者基线抑郁严重程度高(OR=0.81,95%CI=0.79~0.84)、基线生活满意度高(OR=0.96,95%CI=0.95~0.97)的受试者4周末失访率更低;与<30岁年龄组比较,40~49岁年龄组的4周末失访率更低(OR=0.36,95%CI=0.19~0.65);焦虑因子评分高(OR=1.41,95%CI=1.30~1.54)和首次抑郁发作患者(OR=1.52,95%CI=1.10~2.12)的失访率更高。8周末的失访率则与受教育水平(OR=0.42,95%CI:0.21~0.85)和4周末生活满意度变化(OR=0.97,95%CI:0.94~0.99)相关。完全失访的影响因素分析结果显示,基线焦虑水平高(OR=1.38,95%CI=1.27~1.50)、基线抑郁症状严重程度低(OR=0.83,95%CI=0.80~0.86)、较小年龄组(OR=0.44,95%CI=0.25~0.75)、基线生活满意度低(OR=0.96,95%CI=0.95~0.97)与更高的完全失访风险相关。4周末、8周末和完全失访率均与研究中心存在显著关联。结论:本研究发现抑郁症患者年龄较小、首发抑郁、抑郁严重程度低、合并焦虑症状、与疾病相关的生活质量/满意度不高或未改善在急性期队列研究中失访的可能性更高。Objective To explore the influencing factors of loss of follow-up in a cohort study of participants with acute phase depressive disorders.Methods A multicenter prospective cohort of patients with depressive disorders conducted from 2017 to 2021 was followed up at baseline,week 4,and week 8.The general information,disease characteristics,life satisfaction,functional status and other information of the subjects were collected.Loss of follow-up was determined by whether the patients followed the follow-up plan for on-site visits.SAS 9.4 software was used for data description and statistical analysis,and multiple Logistic regression analysis was used to explore the influencing factors of subjects loss to follow-up.Results A total of 1023 patients with acute phase depressive disorders were included in the study.The scores of the 17-item Hamilton depression rating scale,the quality of life enjoyment and satisfaction questionnaire-short form,and Sheehan disability scale were 18.3±6.6,37.7±9.6,and 13.8±7.5,respectively.The loss of follow-up ratios at week 4,week 8 and complete visits were 28.6%(293/1023),19.5%(199/1023),and 13.9%(142/1023),respectively.Multivariate analysis showed that higher depression severity at baseline(OR=0.81,95%CI=0.79-0.84)and higher life satisfaction at baseline(OR=0.96,95%CI=0.95-0.97)were associated with lower loss of follow-up ratio at week 4.Compared with the<30-year group,the loss of follow-up ratio at week 4 in the 40-49-year group was lower(OR=0.36,95%CI=0.19-0.65).Patients with high anxiety factor scores(OR=1.41,95%CI=1.30-1.54)and the first depressive episode(OR=1.52,95%CI=1.10-2.12)had higher loss of follow-up ratio at week 4.The lower loss of follow-up ratio was associated with education level at week 8(OR=0.42,95%CI=0.21-0.85)and life satisfaction at week 4(OR=0.97,95%CI=0.94-0.99).A higher baseline anxiety levels(OR=1.38,95%CI=1.27-1.50),lower severity of baseline depressive symptoms(OR=0.83,95%CI=0.80-0.86),younger age(OR=0.44,95%CI=0.25-0.75),and lower baseline life satisfactio

关 键 词：抑郁症 队列研究 失访 焦虑 生活满意度 影响因素 

分 类 号：R749.4[医药卫生—神经病学与精神病学]