{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T07:16:11Z","timestamp":1788419771242,"version":"build-2803163510"},"reference-count":59,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Depressive disorders pose a significant public health burden, particularly among older adults. However, their prevalence, associated factors, role impairment, and mental health service utilization patterns among community-dwelling older ay -30dults in China remain understudied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The data for this study were obtained from the China Mental Health Survey (CMHS) among participants aged 60 years and older. The World Health Organization Composite International Diagnostic Interview Version 3.0 (CIDI 3.0) was administered to generate mental disorder diagnoses consistent with the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). We calculated weighted prevalence of depressive disorders and applied multivariable logistic regression to identify associated factors, with further analyses of role impairment and mental health service utilization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The final sample encompassed 7,454 older adults. The weighted lifetime and 12-month prevalence of depressive disorders among Chinese community-dwelling older adults were 7.9% (95% CI: 6.4%-9.5%) and 4.1% (95% CI: 3.2%-4.9%), respectively. Multivariable logistic regression analysis showed that older adults with three or more physical illnesses exhibited greater odds of past-year depressive disorders (OR\u00a0=\u00a011.4, 95% CI: 7.0-18.6). Elevated odds were also observed among those with comorbid anxiety and substance use disorders (OR\u00a0=\u00a08.4, 95% CI: 5.5-12.8; OR\u00a0=\u00a08.9, 95% CI: 3.9-20.0, respectively). Among respondents with 12-month depressive disorders, 67.9% had role impairment in household duties, 73.2% in work, 62.2% in relationships, and 60.7% in social life. Only 11.3% of those diagnosed with depressive disorders in the past 12 months utilized any form of mental health service.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Depressive disorders are prevalent among community-dwelling Chinese older adults and are associated with various factors. Patients commonly experienced multi-domain role impairment, whereas mental health service uptake was low, calling for strengthened screening, intervention and accessible care for older adults.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyt.2026.1897102","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T06:44:32Z","timestamp":1788417872000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence, role impairment, and mental health service utilization of depressive disorders among community-dwelling older adults in China"],"prefix":"10.3389","volume":"17","author":[{"given":"Dandan","family":"Wang","sequence":"first","affiliation":[{"name":"Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaofei","family":"Hou","sequence":"additional","affiliation":[{"name":"Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaorui","family":"Liu","sequence":"additional","affiliation":[{"name":"Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital)","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yueqin","family":"Huang","sequence":"additional","affiliation":[{"name":"Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital)","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuiyuan","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Social Medicine and Health Management, School of Public Health, Central South University","place":["Changsha, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingjiang","family":"Li","sequence":"additional","affiliation":[{"name":"Mental Health Institute, The Second Xiangya Hospital, Central South University","place":["Changsha, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tingting","family":"Zhang","sequence":"additional","affiliation":[{"name":"Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital)","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Yan","sequence":"additional","affiliation":[{"name":"School of Government, Peking University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaqin","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Public Health, Jilin University","place":["Changchun, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiufeng","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University","place":["Kunming, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhizhong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University","place":["Yinchuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yifeng","family":"Xu","sequence":"additional","affiliation":[{"name":"Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Li","sequence":"additional","affiliation":[{"name":"Mental Health Centre, West China Hospital, Sichuan University","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangdong","family":"Xu","sequence":"additional","affiliation":[{"name":"The Fourth People\u2019s Hospital in Urumqi","place":["Urumqi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Limin","family":"Wang","sequence":"additional","affiliation":[{"name":"National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongping","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Ministry of Education Key Laboratory of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Fourth Military Medical University","place":["Xi\u2019an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minghui","family":"Li","sequence":"additional","affiliation":[{"name":"Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guangming","family":"Xu","sequence":"additional","affiliation":[{"name":"Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huifang","family":"Yin","sequence":"additional","affiliation":[{"name":"Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1159\/000437299","article-title":"Depression and quality of life in older persons: a review","volume":"40","author":"Sivertsen","year":"2015","journal-title":"Dement Geriatr Cognit Disord"},{"key":"B2","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1097\/00132981-200205000-00012","article-title":"The economic burden of depression with painful symptoms","volume":"64","author":"Birnbaum","year":"2003","journal-title":"J Clin Psychiatry"},{"key":"B3","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1016\/j.euroneuro.2021.04.022","article-title":"Epidemiology and costs of depressive disorder in Spain: the EPICO study","volume":"50","author":"Vieta","year":"2021","journal-title":"Eur Neuropsychopharmacol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(21)00395-3","article-title":"Global, regional, and national burden of 12 mental disorders in 204 countries and territories, 1990\u20132019: a systematic analysis for the Global Burden of Disease Study 2019","volume":"9","year":"2022","journal-title":"Lancet Psychiatry"},{"key":"B5","volume-title":"Diagnostic and Statistical Manual of Mental Disorders","year":"2000"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1001\/jama.289.23.3095","article-title":"The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R)","volume":"289","author":"Kessler","year":"2003","journal-title":"JAMA"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2022.114511","article-title":"Prevalence of depression in older adults: a systematic review and meta-analysis","volume":"311","author":"Hu","year":"2022","journal-title":"Psychiatry Res"},{"key":"B8","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1016\/j.psychres.2016.05.030","article-title":"Prevalence of depression and its associated factors among Chinese elderly people: a comparison study between community-based population and hospitalized population","volume":"243","author":"Li","year":"2016","journal-title":"Psychiatry Res"},{"key":"B9","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1016\/j.jad.2018.07.061","article-title":"Prevalence of major depressive disorder in older adults in China: a systematic review and meta-analysis","volume":"241","author":"Wang","year":"2018","journal-title":"J Affect Disord"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.8263","article-title":"Shared risk factors for depressive disorder among older adult couples in Korea","volume":"6","author":"Han","year":"2023","journal-title":"JAMA Netw Open"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(21)00251-0","article-title":"Prevalence of depressive disorders and treatment in China: a cross-sectional epidemiological study","volume":"8","author":"Lu","year":"2021","journal-title":"Lancet Psychiatry"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2018.3880","article-title":"Comparison of psychosocial variables associated with loneliness in centenarian vs elderly populations in New Zealand","volume":"1","author":"Leitch","year":"2018","journal-title":"JAMA Netw Open"},{"key":"B13","doi-asserted-by":"publisher","first-page":"832","DOI":"10.1186\/s12889-019-7136-z","article-title":"Prevalence of depression among the elderly (60 years and above) population in India, 1997\u20132016: a systematic review and meta-analysis","volume":"19","author":"Pilania","year":"2019","journal-title":"BMC Public Health"},{"key":"B14","doi-asserted-by":"publisher","first-page":"957","DOI":"10.1016\/S0140-6736(21)02141-3","article-title":"Time for united action on depression: a Lancet\u2013World Psychiatric Association Commission","volume":"399","author":"Herrman","year":"2022","journal-title":"Lancet"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291715002251","article-title":"Randomized controlled trial of group cognitive behavioral therapy compared to a discussion group for co-morbid anxiety and depression in older adults","volume":"46","author":"Wuthrich","year":"2016","journal-title":"Psychol Med"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2020.20040454","article-title":"Quality of outpatient depression treatment in patients with comorbid substance use disorder","volume":"178","author":"Coughlin","year":"2021","journal-title":"Am J Psychiatry"},{"key":"B17","article-title":"Depression in the elderly: clinical features and risk factors","volume":"3","author":"S\u00f6zeri-Varma","year":"2012","journal-title":"Aging Dis"},{"key":"B18","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1038\/s43587-022-00203-1","article-title":"Trajectories of depressive symptoms in older adults and associated health outcomes","volume":"2","author":"Agustini","year":"2022","journal-title":"Nat Aging"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.3978","article-title":"Perception of social support and cognitive performance in older adults with depression","volume":"6","author":"Doreste-Mendez","year":"2023","journal-title":"JAMA Netw Open"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2020.579304","article-title":"An exploratory study of the relative effects of various protective factors on depressive symptoms among older people","volume":"8","author":"Worrall","year":"2020","journal-title":"Front Public Health"},{"key":"B21","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1038\/s41398-019-0514-6","article-title":"Mechanisms and treatment of late-life depression","volume":"9","author":"Alexopoulos","year":"2019","journal-title":"Transl Psychiatry"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/58.3.M249","article-title":"Depression in late life: review and commentary","volume":"58","author":"Blazer","year":"2003","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2024.01.256","article-title":"The association between functional disability and depressive symptoms among older adults: findings from the China Health and Retirement Longitudinal Study (CHARLS)","volume":"351","author":"Wang","year":"2024","journal-title":"J Affect Disord"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61414-7","article-title":"Use of mental health services for anxiety, mood, and substance disorders in 17 countries in the WHO world mental health surveys","volume":"370","author":"Wang","year":"2007","journal-title":"Lancet"},{"key":"B25","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1186\/s12877-025-06003-7","article-title":"Factors associated with mental health literacy and demand for mental health services among older adults in China: a cross-sectional study","volume":"25","author":"Chen","year":"2025","journal-title":"BMC Geriatr"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1177\/1403494817722705","article-title":"Mental health service utilization and its associated social factors among elderly people with a mental disability in China: a national population-based survey","volume":"47","author":"Guo","year":"2019","journal-title":"Scand J Public Health"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60660-7","article-title":"Prevalence, treatment, and associated disability of mental disorders in four provinces in China during 2001\u201305: an epidemiological survey","volume":"373","author":"Phillips","year":"2009","journal-title":"Lancet"},{"key":"B28","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1186\/s12888-020-02705-x","article-title":"Mental health stigma and mental health knowledge in Chinese population: a cross-sectional study","volume":"20","author":"Yin","year":"2020","journal-title":"BMC Psychiatry"},{"key":"B29","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1186\/s12877-023-04064-0","article-title":"Prevalence and factors influencing depression among empty nesters in China: a meta-analysis","volume":"23","author":"Song","year":"2023","journal-title":"BMC Geriatr"},{"key":"B30","doi-asserted-by":"publisher","first-page":"S53","DOI":"10.1016\/S0140-6736(19)32389-X","article-title":"Prevalence and risk factors of depression in middle-aged and older adults in urban and rural areas in China: a cross-sectional study","volume":"394","author":"Wu","year":"2019","journal-title":"Lancet"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-016-1269-5","article-title":"The China Mental Health Survey: II. Design and field procedures","volume":"51","author":"Liu","year":"2016","journal-title":"Soc Psychiatry Psychiatr Epidemiol"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(18)30511-X","article-title":"Prevalence of mental disorders in China: a cross-sectional epidemiological study","volume":"6","author":"Huang","year":"2019","journal-title":"Lancet Psychiatry"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-016-1270-z","article-title":"The China Mental Health Survey (CMHS): I. background, aims and measures","volume":"51","author":"Huang","year":"2016","journal-title":"Soc Psychiatry Psychiatr Epidemiol"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.4103\/0366-6999.164930","article-title":"Validity of Chinese Version of the Composite International Diagnostic Interview-3.0 in psychiatric settings","volume":"128","author":"Lu","year":"2015","journal-title":"Chin Med J (Engl)"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1111\/appy.12182","article-title":"Validity and reliability of the Chinese version of the Sheehan Disability Scale (SDS-C)","volume":"7","author":"Leu","year":"2015","journal-title":"Asia Pac Psychiatry"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2025.1626540","article-title":"Prevalence and correlates of anxiety disorders and depressive disorders among older adults with non-communicable diseases: results from China Mental Health Survey","volume":"16","author":"Ge","year":"2025","journal-title":"Front Psychiatry"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1007\/s00406-018-0911-5","article-title":"Lifetime and 12-month prevalence estimates for mental disorders in northeastern Germany: findings from the Study of Health in Pomerania","volume":"269","author":"Asselmann","year":"2019","journal-title":"Eur Arch Psychiatry Clin Neurosci"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2018.18050506","article-title":"Mental disorders around the world: facts and figures from the WHO World Mental Health Surveys","volume":"175","author":"Holingue","year":"2018","journal-title":"Am J Psychiatry"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1016\/S0006-3223(03)00273-7","article-title":"Clinical and health services relationships between major depression, depressive symptoms, and general medical illness","volume":"54","author":"Katon","year":"2003","journal-title":"Biol Psychiatry"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/585063","article-title":"The mediating role of dysfunctional coping in the relationship between beliefs about the disease and the level of depression in patients with rheumatoid arthritis","volume":"2014","author":"Ziarko","year":"2014","journal-title":"Sci World J"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-010-0330-z","article-title":"The association between chronic illness, multimorbidity and depressive symptoms in an Australian primary care cohort","volume":"47","author":"Gunn","year":"2012","journal-title":"Soc Psychiatry Psychiatr Epidemiol"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1007\/s11596-020-2270-5","article-title":"Relationships between chronic diseases and depression among middle-aged and elderly people in China: a prospective study from CHARLS","volume":"40","author":"Jiang","year":"2020","journal-title":"Curr Med Sci"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1002\/da.22964","article-title":"Comorbid anxiety in late-life depression: relationship with remission and suicidal ideation on venlafaxine treatment","volume":"36","author":"Saade","year":"2019","journal-title":"Depress Anxiety"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2022.1067646","article-title":"Network analysis of anxiety and depression in the functionally impaired elderly","volume":"10","author":"Yang","year":"2022","journal-title":"Front Public Health"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.1042\/CS20211106","article-title":"Severe psychiatric disorders and general medical comorbidities: inflammation-related mechanisms and therapeutic opportunities","volume":"136","author":"Teixeira","year":"2022","journal-title":"Clin Sci (Lond)"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.1126\/sciadv.abj3400","article-title":"Social isolation-related depression accelerates ethanol intake via microglia-derived neuroinflammation","volume":"7","author":"Lee","year":"2021","journal-title":"Sci Adv"},{"key":"B47","doi-asserted-by":"publisher","DOI":"10.1002\/da.20918","article-title":"The effect of concurrent substance use disorder on the effectiveness of single and combination antidepressant medications for the treatment of major depression: an exploratory analysis of a single-blind randomized trial","volume":"29","author":"Davis","year":"2012","journal-title":"Depress Anxiety"},{"key":"B48","doi-asserted-by":"publisher","first-page":"525","DOI":"10.1186\/s12889-026-26199-6","article-title":"What are the socioeconomic risk factors of depression among the elderly in China: a systematic review","volume":"26","author":"Li","year":"2026","journal-title":"BMC Public Health"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18062818","article-title":"Rural\u2013urban differences in the factors affecting depressive symptoms among older adults of two regions in Myanmar","volume":"18","author":"Sasaki","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"B50","doi-asserted-by":"publisher","DOI":"10.4103\/jmh.jmh_139_24","article-title":"Determining the prevalence of depression and assessing health-seeking behavior among the geriatric population in urban slums of sea coast city of Saurashtra Region of Gujarat in India: a community-based cross-sectional study","volume":"15","author":"Gandhi","year":"2024","journal-title":"J Midlife Health"},{"key":"B51","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph19042322","article-title":"The moderating effect of social support between loneliness and depression: differences between the young-old and the old-old","volume":"19","author":"Son","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"B52","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-017-1339-3","article-title":"Loneliness and depression in the elderly: the role of social network","volume":"52","author":"Dom\u00e8nech-Abella","year":"2017","journal-title":"Soc Psychiatry Psychiatr Epidemiol"},{"key":"B53","doi-asserted-by":"publisher","first-page":"709","DOI":"10.1186\/s12877-023-04402-2","article-title":"Depression among older adults in an urban slum of Raipur city\u2014a community-based cross-sectional study","volume":"23","author":"Kumar","year":"2023","journal-title":"BMC Geriatr"},{"key":"B54","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000138430.11829.61","article-title":"Depression and comorbidity in community-based patients with epilepsy or asthma","volume":"63","author":"Ettinger","year":"2004","journal-title":"Neurology"},{"key":"B55","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1017\/S104161021300166X","article-title":"Dysthymic disorder in the elderly population","volume":"26","author":"Devanand","year":"2014","journal-title":"Int Psychogeriatr"},{"key":"B56","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2009.10.029","article-title":"Trajectories of recovery of social and physical functioning in major depression, dysthymic disorder and double depression: a 3-year follow-up","volume":"124","author":"Rhebergen","year":"2010","journal-title":"J Affect Disord"},{"key":"B57","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1007\/s10433-011-0213-5","article-title":"Decomposing differences in utilization of health services between depressed and non-depressed elders in Europe","volume":"9","author":"Ladin","year":"2012","journal-title":"Eur J Ageing"},{"key":"B58","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1186\/s12939-023-01983-7","article-title":"Trends in health service needs, utilization, and non-communicable chronic diseases burden of older adults in China: evidence from the 1993 to 2018 National Health Service Survey","volume":"22","author":"Wu","year":"2023","journal-title":"Int J Equity Health"},{"key":"B59","doi-asserted-by":"publisher","first-page":"3576","DOI":"10.1038\/s41598-022-07405-y","article-title":"The impact of healthcare reform on the dynamic changes in health service utilization and equity: a 10-year follow-up study","volume":"12","author":"Guo","year":"2022","journal-title":"Sci Rep"}],"container-title":["Frontiers in Psychiatry"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2026.1897102\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T06:44:33Z","timestamp":1788417873000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2026.1897102\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,3]]},"references-count":59,"alternative-id":["10.3389\/fpsyt.2026.1897102"],"URL":"https:\/\/doi.org\/10.3389\/fpsyt.2026.1897102","relation":{},"ISSN":["1664-0640"],"issn-type":[{"value":"1664-0640","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,3]]},"article-number":"1897102"}}