人格特征、城乡差异与抑郁症状变化的关系

doi:10.19723/j.issn.1671-167X.2023.03.001

摘要/Abstract

摘要：

目的: 抑郁症状的流行已经成为重大的公共卫生问题，研究人格特征与抑郁症状变化之间的关系，并进一步探讨其中的城乡差异，不仅有利于了解抑郁症状在中国的流行趋势，而且能够为政府部门制定个性化的心理健康预防战略提供有利参考。方法: 基于中国家庭追踪调查2018年和2020年的数据，对16 198名18岁以上中国居民进行单因素分析。人格特质有尽责性、外向性、宜人性、神经质和开放性五个维度，按照2018年和2020年抑郁症状的变化情况将16 198名居民分为健康组、抑郁好转组、抑郁恶化组和持续抑郁组。控制性别和教育等因素后采用多项Logistic回归模型检验人格特征是否与抑郁症状的改变相关，并分析了城乡差异在其中的交互作用。结果: 人格特质的五个维度均与抑郁症状的变化呈现显著的相关性，尽责性、外向性、宜人性与抑郁症状呈负相关，而神经质和开放性呈正相关。城乡差异可以调节人格特质与抑郁症状之间的关系，与城市居民相比，农村居民在神经质(OR = 1.14; 95%CI：1.00~1.30) 和抑郁好转组，以及尽责性(OR = 0.79；95%CI：0.68~0.93)和持续抑郁组之间表现出更强的相关性。结论: 人格特质与抑郁症状的变化相关，尽责性、外向性、宜人性与抑郁症状呈负相关，而神经质和开放性呈正相关。抑郁症状好转与神经质呈正相关，持续抑郁与尽责性呈负相关。农村居民的人格特征和持续性抑郁症状以及好转的抑郁症状之间有更强的联系，因此，在中国成年人的心理健康干预和预防计划中，应该进一步考虑人格特质和具有城乡差异的特定策略；同时，本研究结果需要其他针对于独立人群的研究验证。

关键词: 抑郁症状, 城乡差异, 人格特征, 中国成年人

Abstract:

Objective: The prevalence of depressive symptoms has become a significant public health issue in China. Research on the relationship between personality traits and changes in depressive symptoms, as well as further exploration of urban-rural differences, not only benefits for the understanding of the prevalence trend of depression in China, but also provides a useful reference for the government to develop personalized mental health prevention strategies. Methods: Based on the data from the China Family Panel Studies in 2018 and 2020, a univariate analysis was conducted on 16 198 Chinese residents aged 18 years and above. Five dimensions of personality traits were conscientiousness, extraversion, agreeableness, neuroticism and openness. In the study, 16 198 residents were divided into "keep good group", "better group", "worse group" and "keep bad group" according to the changes in depressive symptoms in 2018 and 2020. After controlling for factors, such as gender and education, multinomial Logistic regression analysis was used to examine whether personality traits were associated with changes in depressive symptoms. In addition, we evaluated whether urban-rural and personality traits interacted to influence depressive symptoms. Results: The five dimensions of personality traits were significantly correlated with changes in depressive symptoms. Conscientiousness, extroversion, and agreeableness were negatively associated with depressive symptoms, while neuroticism and openness were positively related. Urban and rural differences moderated the relationship between personality traits and depressive symptoms. Compared with urban residents, rural residents showed stronger correlations between neuroticism (OR=1.14; 95%CI: 1.00-1.30) and the group of depression-recovery, as well as conscientiousness (OR=0.79;95%CI: 0.68-0.93) and the group of persistent-depression. Conclusion: The study finds that personality traits have a significant correlation with changes in depressive symptoms, with certain traits showing a negative or positive relationship. Specifically, higher levels of conscientiousness, extraversion, and agreeableness are associated with lower levels of depressive symptoms, while higher levels of neuroticism and openness are associated with higher levels of depressive symptoms. In addition, the study finds that rural residents have a stronger association between their personality traits and persistent or improved depressive symptoms, which highlights the need for tailoring mental health intervention and prevention programs that should take into account personality traits and urban-rural differences in China. By developing targeted strategies that are sensitive to personality differences and geographic disparities, policymakers and mental health professionals can help prevent and reduce the incidence of depressive symptoms, ultimately improving the overall well-being of Chinese adults. Meanwhile, additional studies in independent populations are needed to corroborate the findings of this study.

Key words: Depressive symptoms, Urban-rural differentials, Personality traits, Chinese adults

中图分类号:

R190

王婷,李乔晟,刘皓冉,简伟研. 人格特征、城乡差异与抑郁症状变化的关系[J]. 北京大学学报（医学版）, 2023, 55(3): 385-391.

Ting WANG,Qiao-sheng LI,Hao-ran LIU,Wei-yan JIAN. Urban-rural differentials in the relationship between personality traits and changes in depressive symptoms[J]. Journal of Peking University (Health Sciences), 2023, 55(3): 385-391.

图/表 4

表1

表2

表3

人格特征与抑郁症状变化的多元Logistic回归分析结果"

Characteristics	Better		Worse		Keep bad
Characteristics	OR^a	95%CI	OR^a	95%CI	OR^a	95%CI
Township (Ref: Urban)
Rural	1.19^***	1.08-1.31	1.10	1.01-1.21	1.19^***	1.08-1.31
Gender (Ref: Female)
Male	0.63^***	0.57-0.70	0.67^***	0.61-0.73	0.51^***	0.46-0.56
Age (Ref: 18-30)/years
30-45	1.20	0.99-1.55	1.01	0.86-1.26	1.49^*	1.15-1.92
> 45	1.18	0.98-1.45	0.82	0.68-1.01	1.36	0.99-1.76
Marital status(Ref: Unmarried)
Married	1.41^***	1.23-1.62	1.20^**	1.05-1.36	1.83^***	1.61-2.09
Work conditions(Ref: Unemployed)
Employed	1.12	0.99-1.27	1.08	0.96-1.21	1.03	0.92-1.16
Education(Ref: Primary)
Middle school	0.88^*	0.78-0.99	0.84^**	0.76-0.94	0.78^***	0.70-0.88
High school	0.81^**	0.70-0.93	0.78^***	0.69-0.88	0.71^***	0.62-0.82
College degree or above	0.82	0.66-1.03	0.76^**	0.61-0.93	0.59^***	0.46-0.76
Chronic diseases(Ref: No)
Yes	1.39^***	1.22-1.58	1.19^**	1.05-1.35	1.40^***	1.24-1.59
Self-evaluated incomestatus (Ref: Low)
Low-middle	0.92	0.76-1.11	0.89	0.75-1.05	0.85	0.71-1.01
Middle	0.77^**	0.65-0.92	0.69^***	0.59-0.80	0.67^***	0.57-0.78
Middle-high	0.71^***	0.58-0.87	0.69^***	0.58-0.83	0.67^***	0.55-0.81
High	0.87	0.70-1.07	0.78^*	0.64-0.94	0.66^***	0.54-0.82
Self-reported health status(Ref: Bad)
Very good	0.65^***	0.54-0.77	0.72^***	0.61-0.85	0.43^***	0.37-0.51
Quite good	0.61^***	0.52-0.70	0.64^***	0.56-0.74	0.36^***	0.32-0.41
Good	0.41^***	0.34-0.50	0.54^***	0.46-0.64	0.21^***	0.18-0.26
General	0.40^***	0.33-0.48	0.51^***	0.43-0.61	0.21^***	0.17-0.25
Personality traits
Conscientiousness	1.02	0.94-1.11	0.91^*	0.84-0.98	0.94	0.86-1.02
Extraversion	1.01	0.94-1.07	0.99	0.94-1.04	0.90^***	0.85-0.96
Openness	1.10^**	1.03-1.17	1.06^*	1.00-1.12	1.18^***	1.11-1.26
Neuroticism	1.32^***	1.23-1.41	1.24^***	1.16-1.31	1.45^***	1.35-1.57
Agreeableness	1.03	0.94-1.13	0.89^**	0.83-0.96	0.93	0.85-1.01
Constant	0.69^*	0.50-0.94	0.94	0.70-1.26	1.27	0.93-1.74

表3

表4

参考文献 24

1	过伟峰, 曹晓岚, 盛蕾, 等. 抑郁症中西医结合诊疗专家共识[J]. 中国中西医结合杂志, 2020, 40 (2): 141- 148.
2	Liu QQ , He HR , Yang J , et al. Changes in the global burden of depression from 1990 to 2017: Findings from the Global Burden of Disease study[J]. J Psychiatr Res, 2020, 126, 134- 140. doi: 10.1016/j.jpsychires.2019.08.002
3	Markon KE , Krueger RF , Watson D . Delineating the structure of normal and abnormal personality: An integrative hierarchical approach[J]. J Pers Soc Psychol, 2005, 88 (1): 139- 157. doi: 10.1037/0022-3514.88.1.139
4	Chioqueta AP , Stiles TC . Personality traits and the development of depression, hopelessness, and suicide ideation[J]. Pers Indivd Dif, 2005, 38 (6): 1283- 1291. doi: 10.1016/j.paid.2004.08.010
5	Fournier J , Jones N , Chase H , et al. Personality dysfunction in depression and individual differences in effortful emotion regulation[J]. Biol Psychiatry, 2017, 81 (Suppl 10): S336- S337.
6	Naragon-Gainey K , Watson D . Consensually defined facets of personality as prospective predictors of change in depression symptoms[J]. Assessment, 2014, 21 (4): 387- 403. doi: 10.1177/1073191114528030
7	Panaite V , Rottenberg J , Bylsma LM . Daily affective dynamics predict depression symptom trajectories among adults with major and minor depression[J]. Affec Sci, 2020, 1 (3): 186- 198. doi: 10.1007/s42761-020-00014-w
8	李磊, 马孟园, 彭红叶, 等. 中国农村地区老年人抑郁症状发生情况及影响因素研究[J]. 中国全科医学, 2021, 24 (27): 3432- 3438. doi: 10.12114/j.issn.1007-9572.2021.00.577
9	张海钟. 人格心理的城乡跨文化实证研究十年成果综述[J]. 社科纵横, 2006, 21 (3): 125- 127.
10	肖凌燕. 基于"大五"人格理论的大学生人格结构分析[J]. 黑龙江教育(高教研究与评估), 2011, (9): 27- 29.
11	Radloff LS . The CES-D scale: A self-report depression scale for research in the general population[J]. Appl Psychol Meas, 1977, 1 (3): 385- 401. doi: 10.1177/014662167700100306
12	Feeney J , Kenny R . Aair cortisol as a risk marker for increased depressive symptoms among older adults during the COVID-19 pandemic[J]. Psychoneuroendocrinology, 2022, 143, 105847. doi: 10.1016/j.psyneuen.2022.105847
13	Hahn E , Gottschling J , Spinath FM . Short measurements of personality: Validity and reliability of the GSOEP Big Five Inventory (BFI-S)[J]. J Res Pers, 2012, 46 (3): 355- 359. doi: 10.1016/j.jrp.2012.03.008
14	Smith KA , Barstead MG , Rubin KH . Neuroticism and conscientiousness as moderators of the relation between social withdrawal and internalizing problems in adolescence[J]. J Youth Adolesc, 2017, 46 (4): 772- 786. doi: 10.1007/s10964-016-0594-z
15	Guo P , Cui J , Wang Y , et al. Spontaneous microstates related to effects of low socioeconomic status on neuroticism[J]. Sci Rep, 2020, 10 (1): 1- 8. doi: 10.1038/s41598-019-56847-4
16	Khoo S , Simms LJ . Links between depression and openness and its facets[J]. Personal Ment Health, 2018, 12 (3): 203- 215. doi: 10.1002/pmh.1417
17	Kim SE , Kim HN , Cho J , et al. Direct and indirect effects of five factor personality and gender on depressive symptoms mediated by perceived stress[J]. PLoS One, 2016, 11 (4): e0154140. doi: 10.1371/journal.pone.0154140
18	Chen J , Qiu L , Ho MHR . A meta-analysis of linguistic markers of extraversion: Positive emotion and social process words[J]. J Res Pers, 2020, 89, 104035. doi: 10.1016/j.jrp.2020.104035
19	Seligman ME . Fall into helplessness[J]. Psychol Today, 1973, 7 (1): 43- 48.
20	Verheij RA . Explaining urban-rural variations in health: A review of interactions between individual and environment[J]. Soc Sci Med, 1996, 42 (6): 923- 935. doi: 10.1016/0277-9536(95)00190-5
21	常韵琪, 郑晓, 李咪咪, 等. 老年慢性病患者抑郁状态及影响因素城乡差异研究[J]. 中国全科医学, 2021, 24 (10): 1254- 1259.
22	Hyde JS , Mezulis AH , Abramson LY . The ABCs of depression: Integrating affective, biological, and cognitive models to explain the emergence of the gender difference in depression[J]. Psychol Rev, 2008, 115 (2): 291- 313.
23	Guo J , Guan LD , Fang LM , et al. Depression among Chinese older adults: A perspective from Hukou and health inequities[J]. J Affect Disord, 2017, 223, 115- 120.
24	Fang MW , Mirutse G , Guo L , et al. Role of socioeconomic status and housing conditions in geriatric depression in rural China: A cross-sectional study[J]. BMJ Open, 2019, 9 (5): e024046.

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Characteristics	n (%)	Rural, n	Urban, n	P
Gender
Female	8 178 (50.49)	3 906	4 272	0.077
Male	8 020 (49.51)	3 942	4 078
Age/years
18-30	2 338 (14.43)	1 019	1 319	< 0.001
>30-45	4 512 (27.86)	2 012	2 500
>45	9 348 (57.71)	4 817	4 531
Marital status
Married	13 955 (86.15)	6 874	7 081	< 0.001
Unmarried	2 243 (13.85)	974	1 269
Working status
Unemployed	3 501 (21.61)	1 216	2 285	< 0.001
Employed	12 697 (78.39)	6 632	6 065
Education
Primary school	6 392 (39.46)	4 098	2 294	< 0.001
Middle school	5 010 (30.93)	2 459	2 551
High school	3 805 (23.49)	1 139	2 666
College degree or above	991 (6.12)	152	839
Chronic diseases
No	13 448 (83.02)	6 478	6 970	0.115
Yes	2 750 (16.98)	1 370	1 380
Self-evaluated income status
Low	1 730 (10.68)	826	904	< 0.001
Low-middle	2 854 (17.62)	1 278	1 576
Middle	7 860 (48.52)	3 634	4 226
Middle-high	2 116 (13.06)	1 097	1 019
High	1 638 (10.12)	1 013	625
Self-reported health status
Very good	2 124 (13.11)	979	1 145	< 0.001
Quite good	7 017 (43.32)	3 099	3 918
Good	2 326 (14.36)	1 120	1 206
General	2 161 (13.34)	1 192	969
Bad	2 570 (15.87)	1 458	1 112
Depression status (2018)
Depression	4 858 (29.99)	2 544	2 314	< 0.001
Healthy	11 340 (70.01)	5 304	6 036
Depression status (2020)
Depression	5 495 (33.92)	2 889	2 606	< 0.001
Healthy	10 703 (66.08)	4 959	5 744
Total	16 198	7 848	8 350

Characteristics	Keep good, n	Better, n	Worse, n	Keep bad, n	P
Gender
Female	3 663	1 324	1 639	1 552	< 0.001
Male	4 676	1 040	1 362	942
Township
Rural	3 805	1 223	1 499	1 321	< 0.001
Urban	4 534	1 141	1 502	1 173
Age/years
18-30	1 260	343	441	294	< 0.001
>30-45	2 491	630	816	575
>45	4 588	1 391	1 744	1 625
Marital status
Married	7 311	2 006	2 595	2 043	< 0.001
Unmarried	1 028	358	406	451
Working status
Unemployed	1 701	506	649	645	< 0.001
Employed	6 638	1 858	2 352	1 849
Education
Primary school	2 886	1 006	1 274	1 226	< 0.001
Middle school	2 712	712	907	679
High school	2 158	509	653	485
College degree or above	583	137	167	104
Chronic diseases
No	7 266	1 870	2 468	1 844	< 0.001
Yes	1 073	494	533	650
Self-evaluated income status
Low	743	271	363	353	< 0.001
Low-middle	1 361	433	581	479
Middle	4 277	1 116	1 367	1 100
Middle-high	1 153	281	374	308
High	805	263	316	254
Self-reported health status
Very good	1 038	318	426	342	< 0.001
Quite good	3 731	1 049	1 279	958
Good	1 425	276	412	213
General	1 323	265	369	204
Bad	822	456	515	777
Personality traits
Conscientiousness	-	-	-	-	< 0.001
Extraversion	-	-	-	-	< 0.001
Openness	-	-	-	-	< 0.001
Neuroticism	-	-	-	-	< 0.001
Agreeableness	-	-	-	-	< 0.001
Total	8 339	2 364	3 001	2 494

Characteristics	Better		Worse		Keep bad
Characteristics	OR^a	95%CI	OR^a	95%CI	OR^a	95%CI
Township
Rural	1.24^***	1.13-1.36	1.17^***	1.07-1.27	1.30^***	1.19-1.43
Personality traits
Conscientiousness	1.02	0.91-1.15	0.89^*	0.80-0.98	0.98	0.87-1.09
Extraversion	1.00	0.92-1.09	0.97	0.90-1.05	0.89^**	0.82-0.96
Openness	1.06	0.98-1.16	1.02	0.94-1.10	1.07	0.98-1.17
Neuroticism	1.28^***	1.17-1.41	1.23^***	1.13-1.34	1.48^***	1.34-1.64
Agreeableness	1.02	0.90-1.14	0.95	0.86-1.05	0.93	0.83-1.04
Township × conscientiousness	0.91	0.77-1.08	0.98	0.85-1.13	0.79^**	0.68-0.93
Township × extraversion	1.00	0.89-1.13	1.05	0.94-1.16	1.02	0.91-1.15
Township × openness	0.92	0.82-1.05	0.94	0.84-1.04	0.92	0.81-1.04
Township × neuroticism	1.14^*	1.00-1.30	1.09	0.96-1.23	1.11	0.96-1.28
Township × agreeableness	1.07	0.90-1.28	0.90	0.78-1.04	1.10	0.93-1.31
Constant	0.25^***	0.24-0.27	0.34^***	0.32-0.36	0.26^***	0.24-0.28

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