中国全科医学 ›› 2025, Vol. 28 ›› Issue (11): 1303-1308.DOI: 10.12114/j.issn.1007-9572.2024.0022

• 专题研究·慢性病共病 • 上一篇    下一篇

我国中老年慢性病患者抑郁现状及其影响因素分析:基于CHARLS数据实证分析

魏萱1, 王宁2, 魏颖2, 陈麒麟1, 赵洋3,4,*()   

  1. 1.250021 山东省济南市,山东第一医科大学附属省立医院门诊部
    2.250002 山东省济南市,山东省卫生健康宣传教育中心
    3.2050澳大利亚悉尼,新南威尔士大学乔治全球健康研究院
    4.3010澳大利亚墨尔本,墨尔本大学人口与全球健康学院
  • 收稿日期:2024-01-10 修回日期:2024-04-20 出版日期:2025-04-15 发布日期:2025-02-06
  • 通讯作者: 赵洋

  • 作者贡献:

    魏萱负责文章的构思与设计、数据整理和分析、论文撰写;王宁负责数据核查、论文修订;魏颖负责文献/资料收集和整理、论文修订;陈麒麟负责论文的修订;赵洋负责最终版本修订、文章的质控与审查,对文章整体负责。

  • 基金资助:
    山东省公共卫生体系建设研究课题项目(GWY202349)

Analysis of Depression Status and Influencing Factors in Middle-aged and Elderly Patients with Chronic Diseases in China: an Empirical Analysis Based on CHARLS Data

WEI Xuan1, WANG Ning2, WEI Ying2, CHEN Qilin1, ZHAO Yang3,4,*()   

  1. 1. Out-patient Department, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
    2. Health Publicity and Education Center of Shandong Province, Jinan 250002, China
    3. The George Institute for Global Health, University of New South Wales, Sydney 2050, Australia
    4. School of Population and Global Health, University of Melbourne, Melbourne 3010, Australia
  • Received:2024-01-10 Revised:2024-04-20 Published:2025-04-15 Online:2025-02-06
  • Contact: ZHAO Yang

摘要: 背景 中老年慢性病患者数量庞大,然而目前关于全国范围内大规模中老年慢性病患者抑郁状况及其影响因素的研究较少。 目的 探讨我国中老年慢性病患者抑郁状况和影响因素,为改善其心理健康状况提供参考依据。 方法 利用中国健康与养老追踪调查项目(CHARLS)在2020年开展的第五轮全国调查数据,共筛选出12 551例中老年慢性病患者作为研究对象,通过抑郁量表(CES-D)测定研究对象的抑郁状况,并用χ2检验和多因素Logistic回归分析探讨影响中老年慢性病患者抑郁状况的主要因素。 结果 中老年慢性病患者中,有抑郁症状的占40.7%(5 111/12 551)。多因素Logistic回归分析结果显示:性别(男:OR=0.613,95%CI=0.553~0.680)、年龄(65~<75岁:OR=0.862,95%CI=0.769~0.965;≥75岁:OR=0.604,95%CI=0.510~0.716)、是否有配偶/伴侣共同生活(有:OR=0.730,95%CI=0.648~0.822)、居住地(农村:OR=1.515,95%CI=1.387~1.654)、文化程度(初中:OR=0.727,95%CI=0.657~0.805;高中及以上:OR=0.561,95%CI=0.488~0.646)、社交情况(1项:OR=0.870,95%CI=0.793~0.956;≥2项:OR=0.866,95%CI=0.779~0.963)、子女关系满意度(满意:OR=0.266,95%CI=0.218~0.324)、吸烟(OR=1.131,95%CI=1.014~1.263)、饮酒(OR=0.873,95%CI=0.795~0.959)、夜间睡眠时长(6~<8 h:OR=0.539,95%CI=0.493~0.590;≥8 h:OR=0.443,95%CI=0.396~0.495)、躯体生活自理能力(BADL)(受损:OR=1.875,95%CI=1.692~2.077)、工具性日常生活活动能力(IADL)(受损:OR=2.251,95%CI=2.030~2.496)、慢性病患病数量(2种:OR=1.202,95%CI=1.076~1.342;3种:OR=1.452,95%CI=1.289~1.636;≥4种:OR=1.954,95%CI=1.749~2.183)是中老年慢性病患者抑郁症状的影响因素(P<0.05)。 结论 中老年慢性病患者抑郁症状发生率为40.7%,情况不容乐观,其抑郁状况受多种因素影响,医疗卫生机构及政策制定者等应关注其心理健康,从个人、家庭、社区等方面采取有针对性的举措进行改善。

关键词: 慢性病, 抑郁, 中老年人群, 中国健康与养老追踪调查, 影响因素分析

Abstract:

Background

There are a large number of middle-aged and elderly patients with chronic diseases. However, there is currently limited research on the depression status and influencing factors of middle-aged and elderly patients with chronic diseases nationwide.

Objective

By exploring the depression status and influencing factors of middle-aged and elderly patients with chronic diseases in China, to provide a reference for improving their mental health status.

Methods

According to the fifth round of national survey data conducted by the China Health and Retirement Longitudinal Study (CHARLS) in 2020, a total of 12 551 middle-aged and elderly patients with chronic diseases were selected as the study objects. The depression status of the study objects was measured using the Center for Epidemiologic Studies Depression Scale (CES-D), and the main factors affecting the depression status of middle-aged and elderly patients with chronic diseases were analyzed using the chi-square test and multivariate Logistic regression.

Results

Among middle-aged and elderly patients with chronic diseases, the proportion of those with depressive symptoms was 40.7% (5 111/12 551). The results of multivariate Logistic regression analysis showed that: gender (male: OR=0.613, 95%CI=0.553-0.680), age (65-<75 years old: OR=0.862, 95%CI=0.769-0.965; ≥75 years old: OR=0.604, 95%CI=0.510-0.716), presence of spouse/partner living together or not (have OR=0.730, 95%CI=0.648-0.822), places of residence (rural: OR=1.515, 95%CI=1.387-1.654), educational levels (junior high school: OR=0.727, 95%CI=0.657-0.805; senior high school and above: OR=0.561, 95%CI=0.488-0.646), social status (1 item: OR=0.870, 95%CI=0.793-0.956; ≥ 2 items: OR=0.866, 95%CI=0.779-0.963), satisfaction with child relationships (satisfaction: OR=0.266, 95%CI=0.218-0.324), smoking (OR=1.131, 95%CI=1.014-1.263), alcohol consumption (OR=0.873, 95%CI=0.795-0.959), nighttime sleep duration (6-<8 h: OR=0.539, 95%CI=0.493-0.590; ≥8 h: OR=0.443, 95%CI=0.396-0.495), BADL (damaged: OR=1.875, 95%CI=1.692-2.077), IADL (damaged: OR=2.251, 95%CI=2.030-2.496), number of chronic diseases (2 types: OR=1.202, 95%CI=1.076-1.342; 3 types: OR=1.452, 95%CI=1.289-1.636; ≥ 4 types: OR=1.954, 95%CI=1.749-2.183) were the influencing factors of depression symptoms in middle-aged and elderly patients with chronic diseases (P<0.05) .

Conclusion

The incidence of depressive symptoms in middle-aged and elderly patients with chronic diseases is 40.7%, and the situation is not optimistic. Their depression is influenced by various factors. Healthcare institutions and policymakers should pay attention to their mental health and take targeted measures from personal, family, community, and other aspects to improve.

Key words: Chronic disease, Depression, Middle-aged and elderly population, China Health and Retirement Longitudinal Study, Root cause analysis

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