Brugha Traolach S, Bebbington Paul E, Singleton Nicola, Melzer David, Jenkins Rachel, Lewis Glyn, Farrell Michael, Bhugra Dinesh, Lee Alison, Meltzer Howard
Brandon Mental Health Unit, Department of Health Sciences, Leicester General Hospital, Gwendolen Road, Leicester LE5 4PW, UK.
Br J Psychiatry. 2004 Nov;185:378-84. doi: 10.1192/bjp.185.5.378.
Trends in health treatments and outcomes in the general population may be used to monitor achievement of health targets.
To investigate changes in mental health services and treatment in Britain over a 7-year period.
National surveys of psychiatric morbidity were completed in 1993 and 2000 in households throughout Great Britain. Standardised interviews were used to establish psychiatric case status and service and treatment utilisation in adults aged 16-64 years.
Use of psychotropic medication doubled in those designated as psychiatric cases. In the non-case-status population antidepressant use rose from 0.16% in 1993 (95% CI 0.07-0.25) to 2.02% in 2000 (95% CI 1.69-2.35). However, the overall prevalence of neurotic and psychotic disorder hardly changed from 1993 to 2000. Use of specialised 'talking treatments'did not increase significantly, except in the non-case group.
Treatment with psychotropic medication alone is unlikely to improve the overall mental health of the nation. A policy based almost exclusively on treatment of identified cases should be augmented by preventive approaches.
普通人群的健康治疗及结果趋势可用于监测健康目标的达成情况。
调查英国7年间心理健康服务与治疗的变化。
1993年和2000年在全英国各家庭中完成了全国性精神疾病发病率调查。采用标准化访谈来确定16 - 64岁成年人的精神病例状况以及服务和治疗的使用情况。
被认定为精神病例的人群中精神药物的使用量翻倍。在非病例状态人群中,抗抑郁药的使用从1993年的0.16%(95%可信区间0.07 - 0.25)升至2000年的2.02%(95%可信区间1.69 - 2.35)。然而,从1993年到2000年,神经症和精神病性障碍的总体患病率几乎没有变化。除了非病例组外,专门的“谈话治疗”的使用没有显著增加。
仅使用精神药物治疗不太可能改善国民的整体心理健康状况。几乎完全基于已确诊病例治疗的政策应辅以预防措施。