| Objective:Depression is one of the major causes of disability burden,which often co-occurs with multiple chronic diseases.Most previous studies focused only on depression co-morbidity with a single chronic disease,not on the complex network of multimorbidity that are common in real life.In this study,we will describe multimorbidity in different depression status by the complex network analysis,to reduce the incidence of multimorbidity and the number of multimorbidity in depression as well as the burden of disease through early intervention.Methods:26171 adults from the National Health and Nutrition Examination Survey(NHANES)between 2005 and 2018 were involved in the study.The validated Patient Health Questionnaire(PHQ-9)was used to assess depression status.Complex network of multimorbidity in different depression status was constructed by R software,which was visualized by Cytoscape software.Gamma coefficient was used to evaluate the correlation between multimorbidity and different depression status.Multivariate ZINB models were used to analyze the association of different depression status and CCI.Results:1.In this study,a total of 26171 subjects were involved,including 19587(74.7%)without depression,4202(16.1%)with mild depression,1479(5.7%)with moderate depression,and 903(3.5%)with severe depression.The prevalence of multimorbidity was 52.5%among those without depression,62.6%among those with mild depression,68.4%among those with moderate depression,and 74.7%among those with major depression.As depression status increased,so did the prevalence of multimorbidity(p for trend<0.001).2.Network analysis of different depression status and multimorbidity showed that,the absolute network density increased with the levels of depression status(from 4.536 to 15.040),and in different depression status,women were greater than men(No depression:5.013 vs.3.581;Mild depression:7.878 vs.4.536;Moderate depression:8.594 vs 7.341;Major depression:15.995 vs.10.265),older people were larger than younger people(No depression:11.698 vs.4.297;Mild depression:16.950 vs.6.446;Moderate depression:20.054vs.9.549;Major depression:21.008 vs.14.324).The top 15 multimorbidity pairs of chronic diseases under different depression status were mainly the combination of hypertension,hyperlipidemia,obesity,arthritis,diabetes,and asthma.3.Analysis of the association between depression status and chronic multimorbidity showed that,positive correlation was identified between multimorbidity and depressive status(Gamma=0.21,p<0.001),and the correlation was different by sex and age,where it was stronger in women than men(females:Gamma=0.23,males:Gamma=0.16),and stronger in the young and the middle-age(young:Gamma=0.30,middle-age:Gamma=0.29,old:Gamma=0.22).4.ZINB regression model of depression status and CCI showed that the increase of depressive status was associated with the increase of CCI in the Count part(CCI>0),and the OR(95%CI)was 1.214(1.182,1.247).Depression was associated with CCI in Logit part(CCI=0),and the OR(95%CI)was 0.691(0.624,0.765).Conclusion:1.The prevalence of multimorbidity increased with the levels of depression status in subjects.2.The absolute network density of complex network of multimorbidity increased with the increase of depression status,that is,the higher the status of depression,the more complex the network of multimorbidity.3.There was a positive correlation between depression status and multimorbidity,that is,with the increase of depression status,the number of multimorbidity increased.4.The status of depression is related to CCI,that is,increasing depression status was associated with increasing CCI... |
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