A Large Sample Survey of Tibetan People on the Qinghai-Tibet Plateau: Current Situation of Depression and Risk Factors

Background: A depressive state is a negative emotional state characterized by abnormal dejection and unpleasant mood. Long-term depressive symptoms can result in psychological disorders such as depression. However, little is known about the depression status and risk factors of the Tibetan people on the Qinghai-Tibet Plateau. Objective: This study explores the depression status of the Tibetan people to better promote ethnic minorities' physical and mental health. Participants and Setting: The Center for Epidemiologic Studies Depression Scale (CES-D) was administered to 24,141 Tibetan people from Yushu Prefecture; the average age was 34.33 years (SD = 9.18, range = 18-94 years). Materials and Methods: Participants completed questionnaires collecting demographic information and evaluating symptoms of depression. Results: The depression prevalence was higher at high altitudes, and there may be a significant positive correlation between depression rates and altitude. Significant differences were found for each demographic variable. Participants with depressive symptoms (scores >= 8) accounted for 52.3% of the total sample, and participants with depression (scores >= 14) accounted for 28.6%. The binary logistic regression results showed that alcohol drinkers, unmarried participants, participants with high self-assessed socioeconomic status, participants with a high income level, and those with a middle-school education were more likely to be depressed. Conclusions: The results provide the first evidence that the prevalence of depression in Tibetans of the Qinghai-Tibet Plateau is higher than that in the general Chinese population and that reported in Western studies, a finding that may be related to cultural differences and chronic hypoxia caused by the high altitude. This paper offers insight into the mental health status of people living in plateau areas and provides a basis for formulating pertinent mental health policy.