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LGBTQ+ 样本中重度抑郁症的全球患病率:系统评价和流行病学研究的荟萃分析。

Global prevalence of major depressive disorder in LGBTQ+ samples: A systematic review and meta-analysis of epidemiological studies.

机构信息

Unit of Psychology and Behavior, School of Public Health, Guangxi Medical University, Naning, Guangxi, China.

Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China.

出版信息

J Affect Disord. 2024 Sep 1;360:249-258. doi: 10.1016/j.jad.2024.05.115. Epub 2024 May 23.

Abstract

BACKGROUND

LGBTQ+ populations have been reported to have higher rates of depression compared with their heterosexual peers. Such data provided us the impetus to conduct a meta-analysis on the worldwide prevalence of major depressive disorder (MDD) in LGBTQ+ populations and moderating factors that contributed to differences in prevalence estimates between studies.

METHODS

A systematic literature search was performed in major international (PubMed, PsycINFO, Web of Science, EMBASE) and Chinese (Chinese Nation Knowledge Infrastructure (CNKI) and WANFANG) databases from dates of inception to 10 December 2021.

RESULTS

48 articles comprising 4,616,903 individuals were included in the meta-analysis. The overall prevalence of MDD was 32.2 % (95%CI: 30.8-33.6 %, I = 99.6 %, τ = 0.284). MDD prevalence was higher in the LGBTQ+ samples from the United States than other countries, though the difference was not significant in moderator analyses. Moderator analyses indicated point and lifetime prevalence of MDD were significantly higher than estimates based on the past year (Q = 6.270, p = 0.043). Furthermore, studies that relied on convenience sampling had a higher prevalence of MDD than those based on other sampling methods (Q = 8.159, p = 0.017). In meta-regression analyses, mean age (B = 0.03, z = 9.54, p < 0.001) and study quality assessment score (B = 0.24, z = 67.64, p < 0.001) were positively associated with pooled prevalence of MDD while mediation data of year of study (B = -0.08, z = -72.55, p < 0.001) and sample size (B = -1.46, z = -37.83, p < 0.001) were negatively associated with pooled prevalence of MDD in LGBTQ+ samples.

CONCLUSIONS

MDD is common among in LGBTQ+ individuals. Considering the negative consequences MDD has on daily life and well-being, appropriate prevention and treatment measures should be provided to vulnerable members of these populations. The findings of this meta-analysis could facilitate identifying at-risk subgroups, developing relevant health policy for LGBTQ+ individuals and allocating health resources from an intersectionality perspective.

摘要

背景

与异性恋同龄人相比,LGBTQ+群体的抑郁症发病率更高。这些数据促使我们对 LGBTQ+人群中重度抑郁症(MDD)的全球患病率进行荟萃分析,并对导致研究间患病率估计差异的调节因素进行分析。

方法

从成立日期到 2021 年 12 月 10 日,我们在主要的国际(PubMed、PsycINFO、Web of Science、EMBASE)和中文(中国国家知识基础设施(CNKI)和万方)数据库中进行了系统的文献检索。

结果

共有 48 篇文章纳入荟萃分析,包含 4616903 人。MDD 的总体患病率为 32.2%(95%CI:30.8-33.6%,I=99.6%,τ=0.284)。来自美国的 LGBTQ+样本中 MDD 的患病率高于其他国家,但在调节分析中差异无统计学意义。调节分析表明,时点患病率和终生患病率均明显高于基于过去 1 年的估计值(Q=6.270,p=0.043)。此外,基于方便抽样的研究比基于其他抽样方法的研究MDD 患病率更高(Q=8.159,p=0.017)。在元回归分析中,平均年龄(B=0.03,z=9.54,p<0.001)和研究质量评估评分(B=0.24,z=67.64,p<0.001)与 MDD 的汇总患病率呈正相关,而研究年份的中介数据(B=-0.08,z=-72.55,p<0.001)和样本量(B=-1.46,z=-37.83,p<0.001)与 LGBTQ+样本中 MDD 的汇总患病率呈负相关。

结论

MDD 在 LGBTQ+个体中很常见。鉴于 MDD 对日常生活和幸福感的负面影响,应该为这些人群中的弱势群体提供适当的预防和治疗措施。本荟萃分析的结果可以帮助确定高危亚组,为 LGBTQ+个体制定相关健康政策,并从交叉性的角度分配卫生资源。

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