| ObjectiveIn recent years,mental disorders have been one of the most important public health issues,and the reports about the epidemic characteristics are also increasing.However,there is a lack of research on Henan population.Therefore,this study is to investigate the prevalence rates and influencing factors of depressive and anxiety symptoms in Henan rural adults by the 2-item Patient Health Questionnaire(PHQ-2)and 2-item Generalized Anxiety Disorder(GAD-2)scales,and further explore the relationship between chronic diseases and depressive and anxiety symptoms,so as to provide scientific evidence for the prevention and control of depression and anxiety.MethodsThe study population were collected from Henan Rural Cohort Study.According to strict exclusion and inclusion criteria,29993 subjects were finally included in this study.The information on demographic factors,lifestyle and chronic disease history were obtained through face-to-face questionnaire survey,physical examination and laboratory detection.The reliability and validity of the Chinese version of GAD-2 were assessed by Cronbach's alpha and receiver operating characteristic curve(ROC),respectively.Binary logistic regression analysis was further applied to explore the potential influencing factors of depression and anxiety,and then the odds ratio(OR)and the corresponding 95%confidence interval(CI)were calculated.Finally,the dose-response relationship between anthropometric indexes(body mass index,systolic blood pressure,diastolic blood pressure,etc.)and depressive and anxiety symptoms was analyzed by restricted cubic spline.Results1.The reliability and validity of the Chinese version of GAD-2 scale:The Cronbach coefficient(Cronbach's alpha)of the scale was 0.806.At the cutoff value of 3,the Youden index reached the maximum of 0.845,and the corresponding sensitivity was 0.865 and the specificity was 0.980.The area under the curve(AUC)was 0.954(95%CI:0.936-0.968)based on the receiver operating characteristic curve.2.Prevalence rates of depressive and anxiety symptoms:The number of patients with depressive and anxiety symptoms in the overall population was 1793 and 1659 respectively,and the corresponding crude prevalence rates were 5.97%(5.71%-6.25%)and 4.94%(4.71%-5.18%).Using the direct standardized method,the age-standardized prevalence rates of depressive and anxiety symptoms were 5.41%(5.17%,5.66%)and 4.94%(4.71%,5.18%),respectively,based on the Chinese Population Census 2010.The crude prevalence rates of depressive and anxiety symptoms were 4.77%(4.40%-5.16%)vs 3.93%(3.59%-4.29%)in men and 6.81%(6.44%-7.19%)vs 6.63%(6.27%-7.01%)in women,and the corresponding age-standardized rates were 5.03%(4.64%-5.45%)vs 3.93%(3.59%-4.28%)in men and 5.69%(5.38%-6.01%)vs 5.60%(5.30%-5.92%)in women,respectively.3.Influencing factors of depressive and anxiety symptoms:Being female,unmarried/widowed/divorced/separated,underweight and having coronary heart disease were positively related to depressive symptoms,while having educational level of junior high school or above,per capita monthly income of 500 Renminbi(RMB)or above,being overweight and obese were negatively associated with depressive symptoms.Being female,having an age of 30-59 years,being unmarried/widowed/divorced/separated,having high levels of physical activity and coronary heart disease were positively related to anxiety symptoms,while having educational level of junior high school or above,per capita monthly income of 500 RMB or above,hypertension,being overweight and obese had negative association with anxiety symptoms.4.Dose-response relationship between chronic diseases and depressive and anxiety symptoms:As the body mass index(BMI)increased,the risk of depressive and anxiety symptoms decreased gradually(both P<0.0001),and there was a linear dose-response relationship between BMI and anxiety symptoms but not depressive symptoms.In addition,with the increasing of systolic and diastolic blood pressure,the risk of anxiety symptoms decreased gradually(both P<0.0001),showing a linear dose-response relationship.Conclusions1.The Chinese version of the 2-item generalized anxiety disorder scale(GAD-2)has good reliability and validity in Henan rural population,showing excellent diagnostic performance.2.The prevalence rates of depressive and anxiety symptoms in Henan rural population are relatively lower than those in other areas of China.Besides,women have significantly higher prevalence rates of depressive and anxiety symptoms than those in men.3.Age,gender,marital status,educational level,average monthly income,drinking,physical activity,BMI,hypertension and coronary heart disease are associated with high risks of depressive or anxiety symptoms.Thus targeted intervention measures should be carried out to prevent and control depression and anxiety.4.The relationship between several common chronic diseases(coronary heart disease,obesity and hypertension)and the risk of depressive and anxiety symptoms are different,which should be further explored in future studies. |
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