健康生态学模型视域下慢性病共病对中老年人抑郁症状的影响  

Study on the impact of chronic disease comorbidities on depression symptoms in middle-aged and elderly people based on health ecology models

作　　者：黄爱文 雒敏[1,2] HUANG Aiwen;LUO Min(School of Medical Administration,Nanjing Medical University,Nanjing 211166,China;Jiangsu Provincial Health Research Institute,Nanjing 211166,China)

机构地区：[1]南京医科大学医政学院,南京211166 [2]江苏省健康研究院,南京211166

出　　处：《中华疾病控制杂志》2025年第2期145-151,共7页Chinese Journal of Disease Control & Prevention

基　　金：教育部人文社会科学研究规划项目(22YJAZH078);江苏省社会科学基金(23SHB013)。

摘　　要：目的 探索慢性病共病对中老年人抑郁症状的影响,为优化我国中老年人慢性病共病患者的心理健康干预策略提供依据。方法 利用2018年中国健康与养老追踪调查(China health and retirement longitudinal study, CHARLS)数据,纳入9 583例>45岁的中老年人作为研究对象,采用SPSS 26.0软件进行χ^(2)检验和二元logistic回归分析模型分析慢性病共病对中老年人抑郁症状的影响,利用R 4.3.3软件构建中老年人慢性病共病患者抑郁症状发生风险的列线图模型。结果 我国中老年人慢性病共病发生率为38.81%,共病中老年人的抑郁症状发生率为61.98%。共病中老年人出现抑郁症状的风险是非共病中老年人的1.556倍(95%CI:1.382~1.753),抑郁症状的发生率随慢性病数量的增加而升高(P<0.001);此外,列线图模型表明中老年人抑郁症状与人口特质、行为特征、政策环境相关(均P<0.05)。结论 慢性病共病增加了我国中老年人出现抑郁症状的风险,应加强对慢性病共病中老年人的健康管理,关注中老年人的心理健康。Objective To explore the impact of chronic disease comorbidities on depression symptoms in middle-aged and elderly people,providing a theoretical basis for optimizing psychological health interventions in this population in China.Methods Data from 9583 middle-aged and elderly individuals in the 2018 China Health and Retirement Longitudinal Study(CHARLS)were analyzed.Chi-square testing and binary logistic regression were performed using SPSS 26.0,and a column chart model for the risk of depression symptoms in those with chronic disease comorbidities was created using R 4.3.3.Results The comorbidity rate of chronic diseases among middle-aged and elderly people in China was 38.81%,and the prevalence of depressive symptoms among those with comorbidities was 61.98%.The likelihood of developing depressive symptoms in those with comorbidities was 1.556 times higher than in those without(95%CI:1.382-1.753).The prevalence of depressive symptoms increased with the number of chronic diseases(P<0.001).Additionally,the column chart model showed that depressive symptoms in middle-aged and elderly people were associated with demographic traits,behavioral characteristics,and the policy environment(all P<0.05).Conclusions Chronic comorbidities increased the risk of depression symptoms among middle-aged and elderly people in China.Therefore,it is necessary to strengthen the health management of middle-aged and elderly people with chronic comorbidities and pay attention to their mental health.

关 键 词：慢性病共病 中老年人 抑郁症状 健康生态学 

分 类 号：R181.3[医药卫生—流行病学] R195.4[医药卫生—公共卫生与预防医学]