1.400038 重庆, 陆军军医大学(第三军医大学)医学心理系
2.100042 北京, 解放军总医院京西医疗区高井门诊部
3.510515 广州, 火箭军广州特勤疗养中心
4.100094 北京, 联勤保障部队第九八四医院医学心理科
Received:20 February 2022,
Revised:2022-04-13,
Published:15 October 2022
移动端阅览
Yuanyuan LI, Xingya LIAO, Xiaoling ZHANG, et al. Characteristics of depressive symptoms and related factors in Chinese veterans[J]. Journal of Army Medical University, 2022, 44(19): 1911-1922.
Yuanyuan LI, Xingya LIAO, Xiaoling ZHANG, et al. Characteristics of depressive symptoms and related factors in Chinese veterans[J]. Journal of Army Medical University, 2022, 44(19): 1911-1922. DOI: 10.16016/j.2097-0927.202202100.
目的
2
研究我国退役军人抑郁症状特点及其相关因素。
方法
2
采用分层方便抽样,对我国三大经济带12个城市2 400名退役军人采用患者健康问卷抑郁量表(Patients’ Health Questionnaire
PHQ-9)及自编一般情况问卷进行抑郁症状调查,采用非参数检验、皮尔森卡方检验、二元Logistic回归进行分析。
结果
2
① 我国退役军人抑郁症状总体发生率39.0%
其中轻度抑郁症状发生率22.1%,中度发生率8.5%,重度发生率8.3%;②女性、城镇、25岁以上、目前患病者抑郁症状发生率及得分高于男性、农村、18~25岁、未患病者(
P
<
0.01),初中及以下受
教育程度、离婚抑郁症状发生率及得分高于大学及以上、未婚和已婚者(
P
<
0.05),家庭人均可支配年收入≤7 400元者抑郁症状发生率高于
>
7 400~16 000元者(
P
<
0.01),工人抑郁症状得分高于党政机关、企事业领导干部(
P
<
0.05),不同水平抑郁症状构成比在除人均GDP外的所有人口学信息上差异有统计学意义(
P
<
0.05);③特殊军事作业环境中服役、服役期间患重病的退役军人抑郁症状发生率及得分高于未在特殊环境服役者、未患重病者(
P
<
0.01),服役<8年、火箭军、参战、集体退役、复员抑郁症状发生率及得分高于服役≥30年、陆军、未参战、达龄/年限退役、退休(
P
<
0.05);退役军人不同水平抑郁症状构成比在除服役职级、立功受奖外的军事职业信息上存在统计学差异(
P
<
0.05);④抑郁症状危险因素为高人均GDP地区、女性、25~30岁、离婚、目前患重病、火箭军、特殊环境服役、服役期间患重病、复员(
P
<
0.05);抑郁症状保护因素为教育程度大学及以上,家庭人均可支配收入
>
7 400~14 000元、
>
25 000~39 000元(
P
<
0.05)。
结论
2
我国退役军人抑郁症状发生率受到性别、年龄、婚姻状况等人口学因素和服役年限、参加的军事作业类型等服役经历影响,复员、集体退役军人群体应引起格外关注。
Objective
2
To investigate the characteristics of depressive symptoms and related factors in Chinese veterans.
Methods
2
A total of 2 400 veterans were selected by stratified sampling and convenient sampling from 12 cities in Chinese 3 economic belts. Self-designed general questionnaire and Patients' Health Questionnaire (PHQ-9) were used to investigate their depressive symptoms. Nonparametric test
Pearson
Chi
-square test and Binary logistic regression analysis were employed to conduct statistical analysis.
Results
2
① The incidence of depression was 39.0% in the subjected Chinese veterans
with mild depression accounting for 22.1%
moderate depression for 8.5%
and severe depression for 8.3%. ②The incidence and score of depressive symptoms were higher in female
living in urban
younger than 25 years and with illness than the male
living in rural areas and healthy participants (
P
<
0.01). Those with educational level less than junior middle school and the divorced had statistically higher incidence and score of depressive symptoms
than those with college or above educational level
and the unmarried and married (
P
<
0.05). The incidence of depression was higher in those with household per capita disposable annual income ≤7 400 Yuan than those of
>
7 400~16 000 Yuan (
P
<
0.01)
and the score of workers was higher than leaders in enterprises and public institutions (
P
<
0.05). There were significant differences in the composition ratio of depressive symptoms at different levels in all demographic information except per capita GDP. ③The incidence and score of depressive symptoms were higher in servicing in special military environment and having seriously disease during service than those not servicing in special military environment and not having disease during serving. The incidence and score of depressive symptoms were higher in serving for 30 years or longer
rocket army
war experience
collective unified released from servicing
and demobilization than those in servicing less than 8 years
army
not being in war
full retirement and retirement (
P
<
0.05). There were significant differences in the composition ratio of depression symptoms at different levels in all military occupation except getting awards and promoting service rank levels (
P
<
0.05). ④ Living in areas with high per capita GDP
female
25~30 years old
being divorced
having seriously disease
rocket army
servicing in special military environment
having severe diseases during service and demobilization were risk factors for the incidence of depression (
P
<
0.05); College and above educational level
household per capita disposable income of
>
7 400~14 000 Yuan and
>
25 000~39 000 Yuan were protective factors (
P
<
0.05).
Conclusion
2
The incidence of depression in Chinese veterans is affected by demographic factors (sex
age and marital status) and military serving experience (years of service and military occupation). Special attention should be paid to those with demobilization and collective ex-servicemen.
ATKINS D,KILBOURNE A M, SHULKIN D. Moving from discovery to system-wide change: the role of research in a learning health care system: experience from three decades of health systems research in the veterans health administration[J]. Annu Rev Public Health, 2017, 38: 467-487. DOI: 10.1146/annurev-publhealth-031816-044255.
THOMPSON J M, VANTIL L D, ZAMORSKI M A, et al . Out of the shadows: mental health of Canadian armed forces veterans[J ] . J Mil Veteran and Family Health, 2014, 11(4): 85-87. DOI: 10.1192/S1749367600004653.
WALLACE D, MEURK C, MCKAY D, et al . Keeping military in mind: the royal Australian & new Zealand college of psychiatrists' military and veterans' mental health network[J ] . Australas Psychiatry, 2020, 28(3): 274-278. DOI: 10.1177/1039856219895199.
VAN BUITEN H, FLYNN E, MORRIS K N. Dog training as a complementary intervention to support Veteran mental health and well-being: a scoping review[J]. Complement Ther Clin Pract, 2021, 44: 101425. DOI: 10.1016/j.ctcp.2021.101425.
加拿大退役军人享受什么福利待遇[EB/OL]. (2018-06-20)[2022-02-20]. http://www.mva.gov.cn/fuwu/xxfw/wgtyjr/201807/t20180721_14010.html.
What benefits do Canadian ex-servicemen enjoy[EB/OL]. (2018-06-20)[2022-02-20]. http://www.mva.gov.cn/fuwu/xxfw/wgtyjr/201807/t20180721_14010.html.
退役军人事务部. 中国退役军人事务年鉴-2020[M]. 北京: 科学技术文献出版社, 2020: 117-142, 410-411.
Department of Veterans Affairs. China veterans affairs yearbook 2020[M]. Beijing: Scientific and Technical Academic Press, 2020: 117-142, 410-411.
退役军人事务部. 中国退役军人事务年鉴-2019[M]. 北京: 科学技术文献出版社, 2019: 319.
Department of Veterans Affairs. China veterans affairs yearbook 2019[M]. Beijing: Scientific and Technical Academic Press, 2019: 319.
MOBBS M C, BONANNO G A. Beyond war and PTSD: the crucial role of transition stress in the lives of military veterans[J]. Clin Psychol Rev, 2018, 59: 137-144. DOI: 10.1016/j.cpr.2017.11.007.
DEREFINKO K J, HALLSELL T A, ISAACS M B, et al . Perceived needs of veterans transitioning from the military to civilian life[J ] . J Behav Health Serv Res, 2019, 46(3): 384-398. DOI: 10.1007/s11414-018-9633-8.
刘志超, 邱文辉, 毛宗福, 等. 伤残退伍军人抑郁及焦虑状况研究[J]. 中国行为医学科学, 2002, 11(1): 91-92. DOI: 10.3760/cma.j.issn.1674-6554.2002.01.048.
LIU Z C, QIU W H, MAO Z F, et al . Study on depression and anxiety of disabled veterans[J ] . Chin J Behav Med Sci, 2002, 11(1): 91-92. DOI: 10.3760/cma.j.issn.1674-6554.2002.01.048.
章玉荣, 井涛, 项倩彤. 老年退伍军人情绪状况及相关因素调查[J]. 中国民康医学, 2008, 20(14): 1652-1653, 1627. DOI: 10.3969/j.issn.1672-0369.2008.14.112.
ZHANG Y R, JING T, XIANG Q T. The eldly veteran emotional status and corretation factors[J]. Med J Chin People's Heal, 2008, 20(14): 1652-1653, 1627. DOI: 10.3969/j.issn.1672-0369.2008.14.112.
冯正直, 陈骁. 我国特殊军事环境军人心理问题研究与展望[J]. 第三军医大学学报, 2016, 38(20): 2199-2204. DOI: 10.16016/j.1000-5404.201607006.
FENG Z Z, CHEN X. Research and perspective of Chinese soldiers' mental health in special military environment[J]. J Third Mil Med Univ, 2016, 38(20): 2199-2204. DOI: 10.16016/j.1000-5404.201607006.
冯正直, 夏蕾. 非战争军事行动军人心理问题特点及影响因素[J]. 第三军医大学学报, 2018, 40(6): 459-465. DOI: 10.16016/j.1000-5404.201710145.
FENG Z Z, XIA L. Characteristics and influencing factors of psychological problems of Chinese soldiers in non-war military operations[J]. J Third Mil Med Univ, 2018, 40(6): 459-465. DOI: 10.16016/j.1000-5404.201710145.
冯正直, 甘丽英, 孙辉, 等. 中国军人抑郁流行病学特征的研究[J]. 第三军医大学学报, 2013, 35(20): 2138-2142. DOI: 10.16016/j.1000-5404.2013.20.003.
FENG Z Z, GAN L Y, SUN H, et al . Epidemiological characteristics of depression in Chinese armymen: a cross-sectional study[J ] . J Third Mil Med Univ, 2013, 35(20): 2138-2142. DOI: 10.16016/j.1000-5404.2013.20.003.
卞崔冬, 何筱衍, 钱洁, 等. 患者健康问卷抑郁症状群量表在综合性医院中的应用研究[J]. 同济大学学报(医学版), 2009, 30(5): 136-140.
BIAN C D, HE X Y, QIAN J, et al . The reliability and validity of a modified patient health questionnaire for screening depressive syndrome in general hospital outpatients[J ] . J Tong ji Univ Med Sci, 2009, 30(5): 136-140.
HUANG Y Q, WANG Y, WANG H, et al . Prevalence of mental disorders in China: a cross-sectional epidemiological study[J ] . Lancet Psychiatry, 2019, 6(3): 211-224. DOI: 10.1016/S2215-0366(18)30511-X.
SHEPHERD S, SHERMAN D K, MACLEAN A, et al . The challenges of military veterans in their transition to the workplace: a call for integrating basic and applied psychological science[J ] . Perspect Psychol Sci, 2021, 16(3): 590-613. DOI: 10.1177/1745691620953096.
MCCASLIN S E, BECKET-DAVENPORT C, DINH J V, et al . Military acculturation and readjustment to the civilian context[J ] . Psychol Trauma, 2021, 13(6): 611-620. DOI: 10.1037/tra0000999.
HALL A L, SWEET J, TWEEL M, et al . Comparing negative health indicators in male and female veterans with the Canadian general population[J ] . BMJ Mil Health, 2022, 168(1): 82-87. DOI: 10.1136/bmjmilitary-2020-001526.
SHI P X, YANG A G, ZHAO Q, et al . A hypothesis of gender differences in self-reporting symptom of depression: implications to solve under-diagnosis and under -treatment of depression in males[J ] . Front Psychiatry, 2021, 12: 589687. DOI: 10.3389/fpsyt.2021.589687.
CAMPBELL S B, GRAY K E, HOERSTER K D, et al . Differences in functional and structural social support among female and male veterans and civilians[J ] . Soc Psychiatry Psychiatr Epidemiol, 2021, 56(3): 375-386. DOI: 10.1007/s00127-020-01862-4.
FRANZ M R, KAISER A P, PHILLIPS R J, et al . Associations of warzone veteran mental health with partner mental health and family functioning: family Foundations Study[J ] . Depress Anxiety, 2020, 37(11): 1068-1078. DOI: 10.1002/da.23083.
ANGEL C M, WOLDETSADIK M A, ARMSTRONG N J, et al . The Enriched Life Scale (ELS): Development, exploratory factor analysis, and preliminary construct validity for US military veteran and civilian samples[J ] . Transl Behav Med, 2020, 10(1): 278-291. DOI: 10.1093/tbm/iby109.
邢占军. 我国居民收入与幸福感关系的研究[J]. 社会学研究, 2011, 25(1): 196-219, 245. DOI: 10.19934/j.cnki.shxyj.2011.01.008.
XING Z J. A study of the relationship between income and subjective well-being in China[J]. Sociol Stud, 2011, 25(1): 196-219, 245. DOI: 10.19934/j.cnki.shxyj.2011.01.008.
李路路, 石磊. 经济增长与幸福感: 解析伊斯特林悖论的形成机制[J]. 社会学研究, 2017, 32(3): 95-120, 244. DOI: 10.19934/j.cnki.shxyj.2017.03.005.
LI L L, SHI L. Economic growth and subjective well-being: analyzing the formative mechanism of easterlin paradox[J]. Sociol Stud, 2017, 32(3): 95-120, 244. DOI: 10.19934/j.cnki.shxyj.2017.03.005.
DEMENESCU L R, STAN A, KORTEKAAS R, et al . On the connection between level of education and the neural circuitry of emotion perception[J ] . Front Hum Neurosci, 2014, 8: 866. DOI: 10.3389/fnhum.2014.00866.
LEVY B S, SIDEL V W. Health effects of combat: a life-course perspective[J]. Annu Rev Public Health, 2009, 30: 123-136. DOI: 10.1146/annurev.publhealth.031308.100147.
LEE H, ALDWIN C M, CHOUN S, et al . Impact of combat exposure on mental health trajectories in later life: longitudinal findings from the VA Normative Aging Study[J ] . Psychol Aging, 2019, 34(4): 467-474. DOI:10.1037/pag0000334.
0
Views
0
下载量
0
CSCD
Publicity Resources
Related Articles
Related Author
Related Institution
京公网安备11010802024621
