中国慢性病前瞻性研究:中国30～79岁成年人抑郁发作的地区及人群分布特征

摘要

目的 描述我国30 ～ 79岁成年人群过去1年内抑郁发作(MDE)的地区及人群分布特征,了解MDE患者的主要临床表现及治疗现状.方法 利用中国慢性病前瞻性研究2004-2008年在基线问卷中收集的人口社会学特征和通过WHO短版复合性国际诊断访谈表(CIDI-SF)诊断1年内MDE情况.采用x2检验和非参数方法比较不同人群MDE表现和治疗情况的差异,采用多元logistic回归模型分析不同人口社会学特征与MDE的关联.结果 共有3281人(6.40‰)在过去1年内有MDE.性别、婚姻状况、职业和家庭收入等与MDE有关.在3 281名MDE患者中,躯体化症状明显,以体重改变、睡眠紊乱和精力丧失为主(分别为99.91％、83.60％和81.59％).女性患者各症状出现的比例和数目均高于男性(P＜0.05).发作后仍有约1/3的患者没有寻求过社会支持和心理治疗,抗精神病药物的使用率仅为8.99％.结论 我国30 ～ 79岁成年MDE在不同特征人群中存在显著性差异,65.19％的患者寻求社会心理治疗或药物治疗.%Objective To examine the socio-demographic patterns on 12-month major depressive episodes (MDE) among Chinese adults aged 30-79 years.Methods Socio-demographic variables from half a million Chinese people aged 30-79 years in the China Kadoorie Biobank study during 2004-2008,were collected.For those showing signs of depression,an additional World Health Organization Composite International Diagnostic Interview-Short Form (CIDI-SF) was face to face administrated,to assess the MDE according to Diagnostic and Statistical Manual of Mental Disorder (DSM)-Ⅳ criteria.Chi squared and non-parametric tests were used to compare the differences between socio-demographic categories,depressive symptoms and help-seeking behaviors.Associations with MDE for soeio-demographic variables were examined by logistic models.Results A total of 3 281 (6.40‰) studied subjects showed an MDE in the preceding 12 months.Gender,marital status,occupation and household income were correlated with MDE.Somatization was common in Chinese MDE patients while symptoms as weight change (99.91％),sleeping disorder (83.60％) and feeling tired (81.59％),stood for the top 3.As for each episode,the proportions and the total number of depressive symptoms appeared higher among females (P＜0.05).One third of the patients did not seek for any social support or psychotherapy with only 8.99％ had ever taken antidepressant drugs.Conclusion Rates of depression varied significantly between social groups in Chinese adults aged 30-79.In this study,only 65.19％ of the MDE patients ever has sought help or received treatment.