The Prevalance of Depression and Anxiety among Elderly People in Dai Rural Areas of Jinggu County Yunnan Province and Its Relationship with Socio-economic Status
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摘要:
目的 分析云南景谷县傣族农村老年人抑郁和焦虑的流行现状及与社会经济地位的关系。 方法 采用多阶段分层随机抽样的方法抽取云南景谷县1409名≥60岁的农村傣族老年人进行现场问卷调查,个人社会经济地位的构建采用主成分分析法。 结果 云南景谷县农村傣族老年人的焦虑、抑郁和合并焦虑抑郁检出率分别为4.8%、52.0%和4.2%,其中男性检出率分别为2.6%、49.4%和2.3%,女性分别为6.8%、54.5%和6.0%;男性焦虑和合并焦虑抑郁的检出率均低于女性(P<0.05)。文化程度、家庭年人均收入和社会经济地位越高者其焦虑和合并焦虑抑郁的检出率越低(均P<0.05)。老年人抑郁的检出率随年龄的增大而升高(P<0.01);慢性病患病数量不同的老年人抑郁检出率差异有统计学意义(P<0.01)。多因素分析结果显示,社会经济地位越低的老年人发生焦虑(OR=0.707,95%CI:0.566~0.883)、抑郁(OR=0.492,95%CI:0.438~0.552)和合并焦虑抑郁(OR=0.602,95%CI:0.469~0.773)的风险越大。 结论 云南景谷县傣族农村老年人抑郁和焦虑的检出率存在明显的社会经济差异。应加强女性、高龄、低社会经济地位、患多种慢性病老年人的心理健康干预,降低其抑郁和焦虑的发生。 Abstract:Objective The aim of this study is to analyze the prevalence of depression and anxiety symptoms and its relationship with the socio-economic position(SEP) among the elderly people in Dai rural areas of Jinggu County, Yunnan province. Methods A multi-stage stratified random sampling method was used to conduct a questionnaire survey among 1409 people aged 60 and over in Dai rural areas of Jinggu County, Yunnan Province. The individual SEP index was constructed using the principal component analysis. Results The prevalence of anxiety symptoms, depression symptoms, and mixed anxiety-depressive disorder symptoms was 4.8%, 52.0%, and 4.2% among them, 2.6%, 49.4%, and 2.3% among the males, and 6.8%, 54.5%, and 6.0% among the females respectively. Females had the higher prevalence of anxiety symptoms and mixed anxiety-depressive disorder symptoms than males(P<0.05). Elderly people with the higher level of education, annual per capita household income and SEP had the lower prevalence of anxiety symptoms and mixed anxiety-depressive disorder symptoms than their counterparts(bothP<0.05).The prevalence of depression symptoms increased with age(P<0.01). The difference in the prevelence of depression symptoms among the elderly people with the different numbers of chronic conditions was statistically significant(P<0.01). The results of multivariate logistic regression analysis showed that the elderly people with lower SEP were more likely to suffer from the anxiety symptoms(OR=0.707, 95%CI: 0.566~0.883), depression symptoms(OR=0.492, 95%CI: 0.438~0.552), and mixed anxiety-depressive disorder symptoms(OR=0.602, 95%CI: 0.469~0.773). Conclusion There are significant socio-economic differences in the prevalence of anxiety symptoms and depression symptoms among the elderly people in Dai rural areas of Jinggu County, Yunnan province. Future mental health interventions should more focus on females, elderly people with advanced age, multiple chronic diseases and low SEP, so as to reduce the occurrence of depression symptoms and anxiety symptoms. -
Key words:
- Anxiety /
- Depression /
- Socioeconomic position /
- Dai ethnic minority /
- Rural areas /
- Old adults
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表 1 云南景谷县农村傣族老年人分性别、年龄组的SEP分布情况[ $n $(%)]
Table 1. Distribution of SEP by gender and age group among Dai ethnic minority older adults in rural Jinggu county,Yunnan province[ $n $(%)]
变量 社会经济地位分组 χ2 P 低 高 性别 男 345(50.0) 345(50.0) 117.885 <0.001* 女 559(77.7) 160(22.3) 年龄组(岁) 60~64 202(55.0) 165(45.0) 12.673 <0.001* 65~69 300(67.3) 146(32.7) 70~74 215(65.5) 113(34.5) ≥75 187(69.8) 81(30.2) 合计 904(64.2) 505(35.8) *P<0.05。 表 2 不同特征人群焦虑和抑郁患病情况
Table 2. Prevalence of depression symptoms and anxiety symptoms with different characteristics
变量 焦虑 抑郁 合并焦虑抑郁 患病人数(n) 患病率(%) 患病人数(n) 患病率(%) 患病人数(n) 患病率(%) 性别 男 18 2.6 341 49.4 16 2.3 女 49 6.8 392 54.5 43 6.0 χ2 13.755 3.669 11.767 P <0.001* 0.055 0.001* 年龄组(岁) 60~64 13 3.5 158 43.1 9 2.5 65~69 21 4.7 245 54.9 20 4.5 70~74 22 6.7 187 57.0 19 5.8 ≥75 11 4.1 143 53.4 11 4.1 χ2 0.752 8.015 1.959 P 0.386 0.005* 0.162 文化程度 文盲 45 6.2 388 53.2 40 5.5 小学及以上 22 3.2 345 50.7 19 2.8 χ2 6.703 0.873 6.359 P 0.010* 0.350 0.012* 家庭年人均收入 低收入 47 7.3 353 54.6 40 6.2 高收入 20 2.6 380 49.8 19 2.5 χ2 16.732 3.284 11.948 P <0.001* 0.070 0.001* 医疗服务可及性 差 39 4.7 414 49.9 33 4.0 好 28 4.8 319 55.0 26 4.5 χ2 0.011 3.501 0.214 P 0.915 0.061 0.643 SEP 低 54 6.0 474 52.4 48 5.3 高 13 2.6 259 51.3 11 2.2 χ2 8.266 0.171 7.919 P 0.004* 0.680 0.005* 慢性病患病数量 0 17 4.1 223 53.2 15 3.6 1 38 4.8 392 49.5 33 4.2 2 10 5.7 99 56.9 9 5.2 ≥3 2 8.3 19 79.2 2 8.3 χ2 1.510 11.010 1.835 P 0.680 0.012* 0.607 合计 67 4.8 733 52.0 59 4.2 *P<0.05。 表 3 老年焦虑和抑郁与社会经济地位关系的多因素Logistic回归分析
Table 3. Multivariate Logistic regression analysis of the relationship between anxiety symptoms and depression symptoms with SEP in the elderly
变量 对照组 B S.E. Wald χ2 P OR OR 95%CI 焦虑 社会经济地位 低 −0.347 0.114 9.298 0.002* 0.707 0.566~0.883 性别 男 0.532 0.111 22.965 <0.001* 1.703 1.370~2.117 年龄组(岁) 60~64 0.037 0.048 0.605 0.437 1.038 0.945~1.141 慢性病患病数量 0 0.630 0.103 37.641 <0.001* 1.878 1.536~2.298 抑郁 社会经济地位 低 −0.710 0.059 143.584 <0.001* 0.492 0.438~0.552 性别 男 0.012 0.058 0.045 0.831 1.012 0.904~1.134 年龄组(岁) 60~64 −0.023 0.026 0.800 0.371 0.977 0.929~1.028 慢性病患病数量 0 0.298 0.057 27.517 <0.001* 1.347 1.205~1.505 合并焦虑抑郁 社会经济地位 低 −0.507 0.127 15.903 <0.001* 0.602 0.469~0.773 性别 男 0.484 0.121 15.982 <0.001* 1.623 1.280~2.057 年龄组(岁) 60~64 0.005 0.053 0.009 0.924 1.005 0.907~1.114 慢性病患病数量 0 0.700 0.112 38.905 <0.001* 2.013 1.616~2.508 *P<0.05。 -
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