实用老年医学

实用老年医学 ›› 2023, Vol. 37 ›› Issue (3): 251-255.doi: 10.3969/j.issn.1003-9198.2023.03.010

• 临床研究 • 上一篇    下一篇

我国中老年抑郁与儿童期不良经历的相关性分层分析

陆伟伟, 刘邦忠, 陈君, 吴一鸣, 朱仕杰, 朱睿   

  1. 200032 上海市,复旦大学附属中山医院康复医学科(陆伟伟,刘邦忠,陈君,吴一鸣);
    200092 上海市,同济大学医学院脊柱脊髓损伤再生修复教育部重点实验室(朱仕杰);
    201619 上海市,同济大学附属养志康复医院辅具资源部(朱睿)
  • 收稿日期:2022-04-10 出版日期:2023-03-20 发布日期:2023-03-13
  • 通讯作者: 朱睿,Email:zhurui08@hotmail.com
  • 基金资助:
    国家重点研发计划(2020YFC2008703);上海市临床重点专科项目(shslczdzk02703);上海市卫生计生系统优秀青年医学人才培养计划(2018YQ32);上海市康复医学会科技创新项目(2022KJCX021)

Association analysis with stratification between depression and adverse childhood experiences in middle-aged and elderly Chinese

LU Wei-wei, LIU Bang-zhong, CHEN Jun, WU Yi-ming, ZHU Shi-jie, ZHU Rui   

  1. Department of Rehabilitation Medicine, Zhongshan Hospital Affiliated to Fudan University, Shanghai 200032, China(LU Wei-wei, LIU Bang-zhong, CHEN Jun, WU Yi-ming);
    Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, School of Medicine, Tongji University, Shanghai 200092, China(ZHU Shi-jie);
    Accessory Resources Department, Yangzhi Rehabilitation Hospital, Tongji University, Shanghai 201619, China(ZHU Rui)
  • Received:2022-04-10 Online:2023-03-20 Published:2023-03-13
  • Contact: ZHU Rui, Email: zhurui08@hotmail.com

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摘要： 目的 探索我国不同个体特征下的儿童期不良经历(ACEs)事件对中老年时期罹患抑郁的影响。方法 基于北京大学发布的中国健康与养老追踪调查数据库(CHARLS),根据研究目的和纳入、排除标准筛选出研究对象,对缺失值采用中位数插补和多重插补方法,利用多因素Logistic回归模型分层分析ACEs后罹患抑郁的风险在不同性别、年龄、教育程度、收入水平亚组的表现,使用泊松回归模型对Logistic回归模型进行敏感性分析,验证其统计结果的稳健性。结果 本研究共纳入13 561名CHARLS研究对象,抑郁患病率为11.03%,94.17%经历过≥1件ACE。Logistic分层分析结果显示,所有亚组抑郁与ACEs的相关性均有统计学意义(P＜0.05),ACEs后罹患抑郁的风险值相对更高的群体包括男性(OR=1.373)、≥60岁(OR=1.327)、小学及以下的教育程度(OR=1.325)、低收入(OR=1.310)。泊松回归模型结果显示Logistic分层分析统计结果稳健。结论 ACEs后罹患抑郁的风险在男性、老龄、低等教育水平、低收入的群体中更高,对这些高风险人群个体特征的初步认识将有助于健康老龄化。

关键词: 抑郁, 儿童期不良经历, 中老年, 分层分析

Abstract: Objective To investigate the association between characteristic-specific adverse childhood experiences (ACEs) events and depression among middle-aged and elderly Chinese. Methods The study subjects were screened from the China Health and Retirement Longitudinal Study (CHARLS) database released by Peking University, based on research objective and inclusion/exclusion criteria. The median interpolation and multiple interpolation methods were adopted for the missing data, and multivariate analysis with stratification and Logistic regression model was adopted to estimate the effect of ACEs on depression in the subjects with different genders, ages, education levels and income. Poisson regression model was used to analyze the sensitivity of Logistic regression model. Results A total of 13 561 samples from CHARLS were enrolled in this study. The prevalence of depression was 11.03%, and 94.17% of the subjects had at least one ACE. Logistic regression analysis with stratification showed that there was statistically significant association between depression and ACEs in all subgroups (P＜0.05), with relatively higher OR in men (OR=1.373), population aged 60 years and older (OR=1.327), with primary school education and below (OR=1.325), and low income (OR=1.310). The results of Poisson regression model showed that Logistic regression model with stratification was statistically robust. Conclusions The risk of depression after ACEs is relatively higher in men, the elderly, or the population with lower level of education and income. The preliminary understanding of these high-risk characteristics will promote healthy aging.

Key words: depression, adverse childhood experience, middle-aged and elderly, stratification analysis

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