title: Incidence, risk, and associated factors of depression in adults with physical and sensory disabilities: A nationwide population-based study.
abstract: BACKGROUND
  Physical disability has been associated with the risk of depression. We examined the incidence, risk, and associated factors of depression in Taiwanese adults with physical/sensory disabilities.
  
  
  METHODS
  Two national databases were used to retrospectively analyze 749,491 ≥20-year-old Taiwanese with physical/sensory disabilities in 2002-2008. The incidence of depression was analyzed by univariate Poisson regression. Risk factors of depression were followed up through 2014 and examined with a Cox proportional hazards model.
  
  
  RESULTS
  Among the study subjects, the incidence of depression was 6.29 per 1000 person-years, with 1.83 per 1000 person-years corresponding to major depression. The subjects' depression risk was affected by disability type, disability severity, gender, age, education, marital status, aboriginal status, monthly salary, residence urbanization level, and Charlson comorbidity index (CCI). Subjects with rare diseases, mild disability, female gender, age 35-44 years, a high school education level, divorced/widowed status, non-aboriginal status, a NT$22,801-28,800 monthly salary, a highly urbanized residence area, or a CCI≥3 were at higher risk for depression.
  
  
  CONCLUSIONS
  Adults with physical/sensory disabilities have a 3.7-fold higher incidence of depression than the general population. Social services departments and family members should take extra measures toward preventing and treating depression in this subpopulation.
authors.affiliation: Department of Public Health, China Medical University, Taichung, Taiwan, R.O.C.|Department of Health Services Administration, China Medical University, Taichung, Taiwan, R.O.C.|Department of Strategy Planning, Buddhist Dalin Tzu Chi Hospital, Chiayi, Taiwan, R.O.C.
authors.forename: Szu-Ching
authors.initials: SC
authors.lastname: Shen
authors.affiliation: Department of Health Services Administration, China Medical University, Taichung, Taiwan, R.O.C.
authors.forename: Kuang-Hua
authors.initials: KH
authors.lastname: Huang
authors.affiliation: Department of Healthcare Administration, Asia University, Taichung, Taiwan, R.O.C.
authors.forename: Pei-Tseng
authors.initials: PT
authors.lastname: Kung
authors.affiliation: Department of Health Services Administration, China Medical University, Taichung, Taiwan, R.O.C.
authors.forename: Li-Ting
authors.initials: LT
authors.lastname: Chiu
authors.affiliation: Department of Health Services Administration, China Medical University, Taichung, Taiwan, R.O.C.
authors.forename: Wen-Chen
authors.identifier: http://orcid.org/0000-0002-9684-0789
authors.initials: WC
authors.lastname: Tsai
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D003863:Depression / Q000453:epidemiology*; D004522:Educational Status; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D055815:Young Adult