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首页> 外文期刊>Psychosomatic Medicine: Journal of the American Psychosomatic Society >Depressive Symptoms and Mortality Risk in a National Sample: Confounding Effects of Health Status.
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Depressive Symptoms and Mortality Risk in a National Sample: Confounding Effects of Health Status.

机译：国家样本中的抑郁症状和死亡率风险：健康状况的混杂影响。

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OBJECTIVE: We examined the association between depressive symptoms and all-cause mortality in a population sample. Published findings on the relation between depressive symptoms and mortality risk point to an inconsistent association and one that is likely influenced by health status. Few studies have assessed this relation in randomly selected population samples. METHODS: Participants were 3617 noninstitutionalized adults, age 25 years or older, from the Americans' Changing Lives Study, an ongoing longitudinal study of a nationally representative sample. Depressive symptoms were measured by the 11-item version of the Center for Epidemiological Studies Depression Scale (CES-D). Cox proportional hazards models estimated the relative risk of mortality as a function of the CES-D scores at baseline. RESULTS: In 7.5 years of follow-up, 542 deaths occurred. Each 1-standard unit increase on the CES-D predicted a 21% increased risk of all-cause mortality, adjusting for age, gender, and race (hazard ratio = 1.21, 95% confidence interval = 1.08 to 1.36, p = .001). This association was weakened somewhat following adjustment for education, income, body mass index, smoking and alcohol consumption (hazard ratio = 1.13, 95% confidence interval = 0.99 to 1.28, p = .06). However, control for self-reported functional limitations or chronic health conditions at baseline effectively eliminated the relationship. Analyses limited to participants with good to excellent health or no functional impairments at baseline showed no association between depressive symptoms and subsequent mortality risk. Secondary analyses showed no association between depressive symptoms and cardiovascular mortality. CONCLUSIONS: These findings from a randomly selected, nationally representative sample do not support the hypothesis that depressive symptoms are independently related to mortality in the general population, after adequate adjustment for the confounding effects of physical health status.
机译：目的：我们研究了人群样本中抑郁症状与全因死亡率之间的关系。有关抑郁症状与死亡风险之间关系的已发表发现表明关联性不一致，并且可能受到健康状况的影响。很少有研究在随机选择的人群样本中评估这种关系。方法：参加者为3617名25岁以上的非住院成年人，来自美国改变生活研究，该研究正在进行中，是一项具有全国代表性的样本的纵向研究。通过流行病学研究中心抑郁量表（CES-D）的11个项目来测量抑郁症状。考克斯比例风险模型根据CES-D分数估算了相对死亡风险。结果：在7.5年的随访中，有542人死亡。 CES-D的每增加1个标准单位，则根据年龄，性别和种族进行调整，全因死亡率的风险将提高21％（危险比= 1.21，95％置信区间= 1.08至1.36，p = .001 ）。在对教育，收入，体重指数，吸烟和饮酒进行调整之后，这种联系有所减弱（危险比= 1.13，95％置信区间= 0.99至1.28，p = .06）。但是，控制基线时自我报告的功能限制或慢性健康状况可以有效消除这种关系。仅限于健康状况良好或基线无功能障碍的参与者的分析显示，抑郁症状与随后的死亡风险之间没有关联。次要分析显示，抑郁症状与心血管疾病死亡率之间无关联。结论：在对身体健康状况的混杂影响进行了适当调整之后，这些从随机选择的，具有全国代表性的样本中得出的结论并不支持抑郁症状与普通人群的死亡率独立相关的假设。

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