The Community Residents Depressed Distribution And Early Intervention Effectiveness Research

Depression is a common mental disease, characterised by high morbidity, high recurrence rates and high suicide morbidity. Early treatment for depression could help prevent deteriorate. If it is not diagnosed and treated early, depression symptoms in 30%patients will become chronic. Studies show that a progressive gradient of psychosocial impairment was associated with a parallelled gradient in the severity of depressive symptom, which ranges from asymptomatic to subthreshold depressive symptoms to symptoms at the minor depression level to symptoms at the major depressive disorder level. Significant increased indisability occurred with each stepwise increment in depressive symptoms severity. Depressive state in community residents may turn into major depression if it is not alleviated. Therefore, early identification of the depressive state and early intervention are important to prevent suicide and to improve the physical and mental health of community residents. The goal of this study was to investigate and early intervene the mild depressive state in community residents.Objective1 Investigate whether gender, age, marital status, educational level, professional type, the income level could lead to depression occurrence, discuss negative life events'impact on depressive state and life quality of community residents, and discuss the personality of depressed community residents;2 Apply early interventions on depressed community residents; Compare acupuncture, psychology(Cognitive Behavioral Therapy, CBT) and combined method on improvement of depressive state and quality of life; Analysis the features and advantages of acupuncture and psychology treatment for depressive state.Method586 community residents were investigated during Nov.2009 to Nov.2010. All community residents were accessed by the following:"quality of life" by the WHOQOL-BREF (World Health Organization Quality of Life-BREF), "depressive state" by the CES-D (Center for Epidemiologic Studies Depression Scale), "negative life event occurrence" by the LES (Life Event Scale) and "personality" by the NEO-FFI (NEO Five-Factor Inventory). Inquire community residents whose CES-D score≥16 with HAMD (Hamilton Depression Rating Scale) and early intervene those whose CES-D score>16 and HAMD score>7,<17. Apply pragmatic randomized controlled method,65 community residents were grouped into control group, acupuncture group, psychology group and combined group. These methods were applied over an 8-week period to evaluate efficacy in improving the depressive state.Results1 Investigation:1.1 There is no significant correlation between gender, age, marital status, smoking status, drinking, physical exercise, self care and depressive symptoms (P< 0.05), and significant correlation between vocational type, education, income level and depressive symptoms (P < 0.05). There is significant difference between CES-D scores of different vocational type, education, income level (P< 0.05);1.2 There is significant positive correlation between negative life event score and CES-D score (P<0.05). There is significant negative correlation between negative life event score and score of quality of life, health evaluation, physiology, psychology, environment and social relationship (P< 0.05). Score of negative work and study event is greatest associated with life quality score(r=-0.376);1.3 Negative work and study event score has greatest correlation with the CES-D score(r=0.515); There is significant correlation between score of negative work and study event and life quality, physiology, psychology, environment and social relationship (P< 0.05). Score of negative work and study event has greatest correlation with health evaluation(r=-0.321);1.4 Negative family life event score has significant negative correlation with life quality, health evaluation, physiology, psychology, environment and social relationship (P<0.05);1.5 Negative social interaction event score has significant correlation with life quality, physiology, psychology, environment and social relationship (P<0.05);1.6 CES-D score showed significant correlation with score of openness, conscientiousness, extraversion, agreeableness and neuroticism (P< 0.05); CES-D score has significant positive correlation with neuroticism and significant negative correlation with openness, conscientiousness, extraversion and agreeableness (P< 0.05); Neuroticism showed greatest correlation with CES-D score(r=-0.592);1.7 There is significant difference between depressed and normal community residents in conscientiousness, extraversion, agreeableness and neuroticism (P<0.05) while no significant difference occurred in openness (P>0.05). 2 Early Intervention:2.1 ITT and PP analysis showed, there is significant difference of HAMD score reduction rate between groups in post-intervention(P< 0.05);2.2 ITT and PP analysis showed, there is significant difference between before and after intervention (P< 0.05); There is significant difference of HAMD and CES-D scores between groups in post-intervention (P< 0.05); the control group showed no significant difference between pre and post intervention (P> 0.05);2.3 The acupuncture group, psychology group and combined group have significant difference between pre and post intervention in life quality, health evaluation, physiology, psychology relationship and environment score(P< 0.05), while the control group showed no significant difference (P> 0.05).Conclusion1 Investigation:1.1 Vocational type, education, income level have significant impact on depressive state;1.2 Negative Life event significantly influence community residents'quality of life, negative work and study event, family life event highly associate with life quality and negative social interaction event highly associate with psychology;1.3 Community residents'depressive state is affected by their personality. The extent of neuroticism intensively influences the emotion of community residents. Community residents in depressive state are prone to be poor in emotion stability, responsibility, easygoing while prone to be more introverts.2 Early interventions:2.1 Early intervention by acupuncture, psychology and combined method could improve community residents'depressive state, combined intervention method is better than pure acupuncture and pure psychology method;2.2 Acupuncture can obviously improve the depressive community residents' anxiety/somatization, sleeping disorders, while psychology can obviously improve cognitive impairment factor;2.3 Early intervention of combined method could significantly improve community residents'satisfaction of life quality, health evaluation, environment satisfaction and social relationship.