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Abstract：
BACKGROUND: Post-stroke depression (PSD) is a common neuropsychiatric complication that affects approximately one-third of stroke patients. The treatment and prognosis of this disease are poor. Socioeconomic status (SES) is closely related to health outcomes; however, only a few previous studies have focused on the association between SES and PSD. Given the substantial population of stroke patients in China, it is crucial to examine the potential risk factors associated with PSD. Conducting studies on this population and investigating the influence of economic conditions can provide valuable guiding theoretical insights into PSD prevention and management.
METHODS: We used data from the 2018 China Health and Retirement Longitudinal Study and selected appropriate samples for analysis. Depression was estimated using the Center of Epidemiologic Studies Depression Scale-10, a validated tool for assessing depression in the general population. Multiple logistic regression analysis was employed to assess the association between SES and PSD and to evaluate any urban-rural differences.
RESULTS: Of the 749 respondents, 370 (49.4%) had depression. Stroke patients with a middle school education demonstrated a greater risk of developing depression than those with a primary school education or below after adjusting for all control variables (odds ratio (OR) = 1.60, 95% confidence interval (CI): 1.03-2.51, P = 0.036). However, stroke patients with a high school education or above had a lower risk of developing depression than those with a primary school education or below (OR = 0.50, 95% CI: 0.28-0.88, P = 0.016). In rural areas, stroke patients with a high school or above education level had lower rates of depression than those with a primary school education or below (OR = 0.44, 95% CI: 0.21-0.91, P = 0.027). This difference was not significant in urban areas.
CONCLUSIONS: SES significantly influences the occurrence of PSD, which is reflected by education attainment and annual household expenditures. Education attainment was an independent influence on PSD, with a more pronounced effect in rural versus urban areas. We hope to reduce the prevalence of PSD and enhance the comprehensive management of this disease by modifying the influencing factors. Sex, self-reported health status, activities of daily living, night-time sleep duration, and life satisfaction also influenced the occurrence of PSD.
METHODS: We used data from the 2018 China Health and Retirement Longitudinal Study and selected appropriate samples for analysis. Depression was estimated using the Center of Epidemiologic Studies Depression Scale-10, a validated tool for assessing depression in the general population. Multiple logistic regression analysis was employed to assess the association between SES and PSD and to evaluate any urban-rural differences.
RESULTS: Of the 749 respondents, 370 (49.4%) had depression. Stroke patients with a middle school education demonstrated a greater risk of developing depression than those with a primary school education or below after adjusting for all control variables (odds ratio (OR) = 1.60, 95% confidence interval (CI): 1.03-2.51, P = 0.036). However, stroke patients with a high school education or above had a lower risk of developing depression than those with a primary school education or below (OR = 0.50, 95% CI: 0.28-0.88, P = 0.016). In rural areas, stroke patients with a high school or above education level had lower rates of depression than those with a primary school education or below (OR = 0.44, 95% CI: 0.21-0.91, P = 0.027). This difference was not significant in urban areas.
CONCLUSIONS: SES significantly influences the occurrence of PSD, which is reflected by education attainment and annual household expenditures. Education attainment was an independent influence on PSD, with a more pronounced effect in rural versus urban areas. We hope to reduce the prevalence of PSD and enhance the comprehensive management of this disease by modifying the influencing factors. Sex, self-reported health status, activities of daily living, night-time sleep duration, and life satisfaction also influenced the occurrence of PSD.
摘要：
背景：卒中后抑郁（PSD）是一种常见的神经精神并发症，影响约三分之一的卒中患者。本病的医治和预后较差。社会经济地位(SES)与健康结果密切相关；然而，以前只有少数研究关注SES和PSD之间的关联。鉴于中国有大量的中风患者，研究与PSD相关的潜在危险因素至关重要。对该人群进行研究并调查经济条件的影响可以为PSD的预防和管理提供有价值的指导性理论见解。
方法：我们使用了2018年中国健康与退休纵向研究的数据，并选择了合适的样本进行分析。使用流行病学研究中心抑郁量表-10估计抑郁，这是一种评估普通人群抑郁的有效工具。采用多元逻辑回归分析评估SES和PSD之间的关联，并评估任何城乡差异。
结果：在749名受访者中，370人（49.4%）患有抑郁症。调整所有控制变量后，受过中学教育的卒中患者患抑郁症的风险高于受过小学或小学以下教育的患者（比值比（OR）=1.60，95％置信区间（CI）：1.03-2.51，P=0.036）。然而,高中及以上文化程度的卒中患者患抑郁症的风险低于小学及以下文化程度的卒中患者(OR=0.50,95%CI:0.28~0.88,P=0.016).在农村地区,高中及以上文化程度的卒中患者的抑郁发生率低于小学及以下文化程度的卒中患者(OR=0.44,95%CI:0.21-0.91,P=0.027).这种差异在城市地区并不显著。
结论：SES显著影响PSD的发生，这反映在受教育程度和家庭年度支出上。受教育程度是对PSD的独立影响，在农村和城市地区有更明显的影响。我们希望通过修改影响因素来降低PSD的患病率，加强对该病的综合管理。性,自我报告的健康状况，日常生活活动,夜间睡眠持续时间，生活满意度也影响PSD的发生。
方法：我们使用了2018年中国健康与退休纵向研究的数据，并选择了合适的样本进行分析。使用流行病学研究中心抑郁量表-10估计抑郁，这是一种评估普通人群抑郁的有效工具。采用多元逻辑回归分析评估SES和PSD之间的关联，并评估任何城乡差异。
结果：在749名受访者中，370人（49.4%）患有抑郁症。调整所有控制变量后，受过中学教育的卒中患者患抑郁症的风险高于受过小学或小学以下教育的患者（比值比（OR）=1.60，95％置信区间（CI）：1.03-2.51，P=0.036）。然而,高中及以上文化程度的卒中患者患抑郁症的风险低于小学及以下文化程度的卒中患者(OR=0.50,95%CI:0.28~0.88,P=0.016).在农村地区,高中及以上文化程度的卒中患者的抑郁发生率低于小学及以下文化程度的卒中患者(OR=0.44,95%CI:0.21-0.91,P=0.027).这种差异在城市地区并不显著。
结论：SES显著影响PSD的发生，这反映在受教育程度和家庭年度支出上。受教育程度是对PSD的独立影响，在农村和城市地区有更明显的影响。我们希望通过修改影响因素来降低PSD的患病率，加强对该病的综合管理。性,自我报告的健康状况，日常生活活动,夜间睡眠持续时间，生活满意度也影响PSD的发生。
