Abstract:Objective To investigate the influencing factors of relapse in elderly patients with depression. Methods A total of 220 elderly patients with depression who were admitted to Ningbo Kangning Hospital, Zhejiang Province from February 2019 to February 2020 were selected as the research subjects. After a year of follow-up, the patients were divided into recurrence group (90 cases) and non-relapse group (130 cases) according to the follow-up results. The gender, age, marital status, onset form, family history, associated physical diseases, cognitive dysfunction, treatment compliance, major life events, sleep disturbances, the number of onsets, and the total course of the disease were compared between the two groups. Multivariate unconditional logistic regression analysis was used to observe the risk factors affecting the recurrence of depression in the elderly. Results There were statistically significant differences in marital status, onset form, family medical history, associated physical disease, cognitive dysfunction, treatment compliance, major life events, sleep disturbance, and incidence of disease between the two groups (P < 0.05). Stepwise regression analysis was performed by multivariate unconditional logistic regression, associated with physical disease (OR = 3.934, 95%CI: 2.706-5.159), cognitive impairment (OR = 2.336, 95%CI: 1.561-3.118), treatment compliance (OR = 3.458, 95%CI: 2.330-4.568), major life events (OR = 5.440, 95%CI: 3.987-6.896), and sleep disturbance (OR = 1.989, 95%CI: 1.268-2.721) were risk factors for relapse in elderly patients with depression (P < 0.05). Conclusion Relapse in elderly patients with depression is common in clinical practice, accompanied by physical disease, cognitive dysfunction, treatment compliance, major life events, and sleep disturbance are risk factors for relapse, and targeted interventions should be taken to reduce the relapse rate.
[1] 黄静文,魏燕燕,刘艳.老年抑郁症患者体重降低的影响因素分析[J].中国医药导报,2021,18(2):114-117.
[2] 张惠玲,陈莹.老年抑郁症患者认知功能的影响因素及干预方法分析[J].现代实用医学,2020,32(11):1367-1369.
[3] 李洁,王岚,李拴荣,等.河南省某精神专科医院老年抑郁症患者营养现状及相关因素分析[J].现代预防医学,2021,48(13):2347-2350,2367.
[4] 周丽英,陈继珍,张胡,等.复发性自然流产抑郁情绪影响因素分析及护理对策[J].护理实践与研究,2020,17(8):27-29.
[5] 冉柳毅,况利,刘川,等.复发性抑郁障碍患者尿酸水平及其相关因素分析[J].重庆医科大学学报,2020,45(1):91-94.
[6] 郭冀丹,李巧平,宫敏.复发性流产孕妇的焦虑、抑郁状况与社会支持、家庭功能的关系[J].海南医学,2020,31(20):2651-2654.
[7] 庄海林,贾丽娜,李丹,等.福州市社区老年慢性病患者抑郁症现状及影响因素调查研究[J].中国预防医学杂志,2019,20(9):803-807.
[8] 李盼盼.初发老年脑梗死患者并发抑郁症的危险因素分析[J].现代诊断与治疗,2020,31(9):1465,1488.
[9] Ma J,Rosas LG,Lv N,et al. Effect of integrated behavioral weight loss treatment and problem-solving therapy on body mass index and depressive symptoms among patients with obesity and depression:the RAINBOW randomized clinical trial [J]. JAMA,2019,321(9):869-879.
[10] 冯婷婷,张洪艳,张会杰,等.焦虑性抑郁症患者皮质醇节律紊乱及影响因素[J].中华行为医学与脑科学杂志,2019,28(6):499-504.
[11] 姚烨,杨春燕,许艳秋,等.认知行为治疗对老年抑郁症患者认知功能改善的对照观察[J].国际精神病学杂志,2020,47(1):67-70.
[12] 中华医学会精神病学分会.中国精神障碍分类与诊断标准第三版(精神障碍分类)[J].中华精神科杂志,2001, 34(3):184-188.
[13] 周婧雅,白雪,崔胜男,等.我国ICD-10疾病分类编码质量的系统评价[J].中国医院管理,2015,35(12):32-35.
[14] 冯笑,郭丽娜,刘堃.精简版流调中心抑郁量表在社区老年人中的信效度评价[J].中国现代医学杂志,2016, 26(10):133-137.
[15] 中国痴呆与认知障碍诊治指南写作组,中国医师协会神经内科医师分会认知障碍疾病专业委员会.2018中国痴呆与认知障碍诊治指南(五):轻度认知障碍的诊断与治疗[J].中华医学杂志,2018,98(17):1294-1301.
[16] Buysse DJ,Reynolds CF,Monk TH,et al. The pittsburgh sleep quality index:a new instrument for psychiatric practice and research [J]. Psychiatry Res,1989,28(2):193-213.
[17] 朱建立,张红星,顾丽华,等.抑郁症与肠道菌群相关性研究进展[J].国际精神病学杂志,2019,46(4):594-596, 600.
[18] Besora-Moreno M,Llauradó E,Tarro L,et al. Social and economic factors and malnutrition or the risk of malnutrition in the elderly: a systematic review and Meta-Analysis of observational studies [J]. Nutrients,2020,12(3):737.
[19] Silvernale C,Kuo B,Staller K. Lower socioeconomic status is associated with an increased prevalence of comorbid anxiety and depression among patients with irritable bowel syndrome: results from a multicenter cohort [J]. Scand J Gastroentero,2019,54(9):1070-1074.
[20] 赵禹,李树亚,李峥.社区老年轻度认知障碍患者合并抑郁的现状调查及影响因素分析[J].中华现代护理杂志,2019,25(10):1274-1279.
[21] 高会莹,程秀丽,江美娜,等.老年住院患者抑郁症状与衰弱状况关系的研究[J].中华老年医学杂志,2019,38(6):631-634.
[22] 邢荔函,杜立琛,牛越,等.老年抑郁症患病危险因素研究[J].中国卫生统计,2019,36(6):866-869.
[23] 李雯曦,刘国顺,彭程,等.老年心力衰竭患者营养状态及其危险因素分析[J].中华老年医学杂志,2020,39(2):137-142.
[24] 荣健,戈艳红,孟娜娜,等.2010—2019 年中国老年人抑郁症患病率的 Meta分析[J].中国循证医学杂志,2020, 20(1):26-31.
[25] 徐双,陈晶,雷威,等.成都地区城乡居民的精神健康素养调查[J].中国心理卫生杂志,2020,34(10):834-840.
[26] Perna S,Rondanelli M,Spadaccini D,et al. Are the therapeutic strategies in anorexia of ageing effective on nutritional status A systematic review with meta-analysis [J]. J Hum Nutr Diet,2019,32(1):128-138.
[27] 汪向东,王希林,马弘.心理卫生评定量表手册(增订版)[M].北京:中国心理卫生杂志社,1999.