抑郁症状评分和特定抑郁症状与全因死亡率和心血管疾病死亡率的关系。

IF 3.6 3区 医学 Q1 PSYCHIATRY
Tao Liu, Lili Wang, Zhijian Zhu, Bing Wang, Zhigang Lu, Yesheng Pan, Lifang Sun
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引用次数: 0

摘要

背景:有报道称,抑郁症的存在与全因死亡率和心血管疾病(CVD)死亡率的增加有关。然而,针对某些特定抑郁症状的研究却很少。我们的目的是评估抑郁症状评分和某些特定抑郁症状对全因死亡率和心血管疾病死亡率的影响:在本队列研究中,所有 18 岁或以上的参与者都参加了 2005 年至 2014 年的美国国家健康与营养调查(NHANES)。抑郁症状评分采用经过验证的9项患者健康问卷抑郁量表(PHQ-9)进行评估,该量表的评分范围为0至27分,PHQ-9评分≥10分为抑郁症。结果事件为全因死亡率和心血管疾病死亡率,随访时间为2005年至2014年。通过加权多变量比例危险模型研究了抑郁症状评分和某些特定抑郁症状与全因死亡率和心血管疾病死亡率的关系:共有26,028名年龄≥18岁的参与者参与了统计分析,其中男性12,813人(49.2%),女性13,215人(50.8%),平均(标清)年龄为47.34(18.86)岁。在平均(标清)9.32(3.20)年的随访期间,共记录了 3261 例死亡病例,其中 826 例为心血管疾病死亡。抑郁症患者的全因死亡率为16.87/1000人年。心血管疾病死亡率为 4.53/1000 人-年。在完整模型(模型 3)中,抑郁症状评分升高与全因死亡风险增加(抑郁症状评分最高组:调整后危险比为 1.63;95% CI 为 1.44-1.85)和心血管疾病死亡风险增加(抑郁症状评分最高组:调整后危险比为 1.73;95% CI 为 1.34-2.24)独立相关。构成 PHQ-9 的所有 9 种特定抑郁症状都与全因死亡风险增加有关。然而,只有3种症状与心血管疾病死亡风险的增加无显著相关性,这3种症状包括失眠或睡眠过多、食欲不振或暴饮暴食以及自杀意念:结论:抑郁症状得分升高与美国成年人全因死亡和心血管疾病死亡风险增加密切相关。此外,所有 9 种特定抑郁症状都与全因死亡率高有关。然而,失眠或睡眠过多、食欲不振或暴饮暴食以及自杀倾向可能不会增加心血管疾病的死亡风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Association of both depressive symptoms scores and specific depressive symptoms with all-cause and cardiovascular disease mortality.

Background: The presence of depression related to an increased risk of all-cause and cardiovascular disease (CVD) mortality has been reported. However, studies conducted on certain specific depressive symptoms are scarce. Our purpose was to assess the effect of both depressive symptoms scores and certain specific depressive symptoms on all-cause and CVD mortality.

Methods: In the present cohort study, all participants, aged 18 years or older, were enrolled in the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2014. Depressive symptoms score was assessed using the validated 9-item Patient Health Questionnaire Depression Scale (PHQ-9), which ranges from 0 to 27, with a PHQ-9 score ≥ 10 diagnosed as depression. The outcome events were all-cause and CVD mortality, which were followed up from 2005 to 2014. The associations of both depressive symptoms score and certain specific depressive symptoms with all-cause and CVD mortality were examined by weighted multivariable proportional hazards models.

Results: A total of 26,028 participants aged ≥ 18 years were included in the statistical analysis, including 12,813 (49.2%) males and 13,215 (50.8%) females, with a mean (SD) age of 47.34 (18.86) years. During the 9.32 (3.20) years of mean (SD) follow-up, 3261 deaths were recorded, of which 826 were cardiovascular deaths. All-cause mortality was 16.87/1000 person-years in subjects with depression. In terms of CVD mortality, these figures were 4.53/1000 person-years. In the full model (model 3), elevated depressive symptoms scores were independently associated with an increased risk of all-cause mortality (Highest depression symptom score group: adjusted hazard ratio, 1.63; 95% CI 1.44-1.85) and CVD mortality (Highest depression symptom score group: adjusted hazard ratio, 1.73; 95% CI 1.34-2.24). All 9 specific depressive symptoms that make up the PHQ-9 were related to an increased risk of all-cause mortality. However, only 3 symptoms, including trouble sleeping or sleeping too much, poor appetite or overeating, and suicidal ideation, were no significantly associated with an increased risk of CVD mortality.

Conclusions: The elevated depressive symptoms scores were strongly associated with an increased risk of all-cause and CVD mortality in US adults. Furthermore, all 9 specific depressive symptoms were associated with high all-cause mortality. However, trouble sleeping or sleeping too much, poor appetite or overeating, and suicidal ideation might not increase the risk of CVD mortality.

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来源期刊
CiteScore
6.60
自引率
2.70%
发文量
43
审稿时长
>12 weeks
期刊介绍: Annals of General Psychiatry considers manuscripts on all aspects of psychiatry, including neuroscience and psychological medicine. Both basic and clinical neuroscience contributions are encouraged. Annals of General Psychiatry emphasizes a biopsychosocial approach to illness and health and strongly supports and follows the principles of evidence-based medicine. As an open access journal, Annals of General Psychiatry facilitates the worldwide distribution of high quality psychiatry and mental health research. The journal considers submissions on a wide range of topics including, but not limited to, psychopharmacology, forensic psychiatry, psychotic disorders, psychiatric genetics, and mood and anxiety disorders.
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