目的：了解成都地区55周岁及以上人群中抑郁症患病率及其影响因素。方法：本文采用分层随机整群抽样方法，从成都市所辖地区抽取10个区市县。按农业人口和非农业人口所占比例确定应查城乡55周岁及以上人口数。调查由两阶段组成，先用流调用抑郁自评量表(CES-D)筛查，然后用DSM-Ⅲ-R定式临床检查(SCID-P)进行诊断复查。应查5587人，实查5385人，其中5350人完成了CES-D检查，35人因耳聋(且不识字)，失语无法完成CES-D，改用SCID-P询问家属或其他知情者。外出171人，拒查31人，漏查率3.6%。结果：发现CES-D评分≥16分者168人，为被调查人口的3.14%。诊断复查发现各类抑郁症的患病率分别为：适应性障碍0.85%。心境恶劣障碍0.76%，躯体疾病所致抑郁心境0.52%，重型抑郁症0.45%。各类抑郁症总患病率为2.62%，其中男性1.60%，女性：3.54%，女性患病率显著高于男性。多元逐步回归分析表明日常生活能力受损、女性以及认知功能下降老人有抑郁症状者较多。结论：本文结果表明我国抑郁症患病率较低。适应性障碍,心境恶劣障碍和躯体疾病引起的抑郁是主要的抑郁类型。%Objective: To examine the prevalence and the relevant factors of senile depressive disorders in the urban and rural areas in Chengdu, Southwest China. Method: This study was conducted among residents aged 55 years or above in urban and rural areas. They were selected by stratified random sampling from 10 of 19 districts, cities and counties of Chengdu area in Sichuan province. The study design consisted of a screening stage followed by a clinical interview stage with structured clinical interview instrument for DSM-III-R (SCID-P). The cut-off point in screening was CES-D≥16 (Center for Epidemiological Studies of Depression). 5385 subjects were examined among 5587 old residents. 171 persons went out and other 31 persons refused the interview. The rate of dropout was 3.6%. 5350 persons were examined with the CES-D and 35 deaf and illiterate subjects were assessed from their family members or other informants with SCID-P. Result: The prevalence of depressive symptoms (CES-D≥16) was 3.14%. The prevalence of adjustment disorder, dysthymia, depressive state related to physical disease and major depression were 0.85%, 0.76%, 0.52% and 0.45% respectively. The overall prevalence of depression was 2.62% (1.60% in man and 3.54% in women). The prevalence of depression was significantly higher in women than that in men. The risk factors related to depression included impairment of daily living function and cognitive function, being a woman. Conclusion: The prevalence of depression in elderly in Chengdu area was lower than that in western countries. Among all disorders with depressive mood, adjustment disorder, dysthymia and depressive state related to physical disease were more common in Chengdu elderly.
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