Copeland John R M, Beekman Aartjan T F, Braam Arjan W, Dewey Michael E, Delespaul Philippe, Fuhrer Rebecca, Hooijer Christopher, Lawlor Brian A, Kivela Sirkka-Liisa, Lobo Anthony, Magnusson Halgrimur, Mann Anthony H, Meller Ingeborg, Prince Martin J, Reischies Friedel, Roelands Marc, Skoog Ingmar, Turrina Cesare, deVries Marten W, Wilson Kenneth C M
Department of Psychiatry, University of Liverpool, UK.
World Psychiatry. 2004 Feb;3(1):45-9.
The data from nine centres in Europe which had used the Geriatric Mental Scale (GMS) AGECAT were analysed to compare prevalence of diagnoses in subjects aged 65 years and over living in the community. Levels of depressive illness were: Iceland 8.8%, Liverpool 10.0%; Zaragoza 10.7%; Dublin 11.9%; Amsterdam 12.0%; Berlin 16.5%; London 17.3%; Verona 18.3% and Munich 23.6%. Taking all levels of depression, five high (Amsterdam, Berlin, Munich, London and Verona) and four low (Dublin, Iceland, Liverpool, Zaragoza) scoring centres were identified. Meta-analysis of all 13,808 subjects yielded a mean level of depression of 12.3% (95% CI 11.8-12.9), 14.1% for women (95% CI 13.5-14.8) and 8.6% for men (95% CI 7.9-9.3). Symptom levels varied between centres: 40% of the total study population in Amsterdam reported depressive mood against only 26% in Zaragoza. To incorporate studies from other centres using other methods for depression identification, the EURO-D scale was developed from 12 items of the GMS and validated against other scales and expert diagnosis. A two factor solution emerged, an 'affective suffering factor' and a 'motivation factor'. The EURO-D scale was applied to 14 population based surveys. Depression score tended to increase with age unlike levels of prevalence of depression. Large between centre differences were evident in levels of depression unexplained by age, gender or marital status. These data show that depressive illness defined as suitable for intervention is common among older people in Europe. Opportunities for effective treatment are almost certainly being lost. Levels of depressive symptoms vary significantly between high and low scoring centres, prompting the next phase of this study, an examination of risk factors in Europe.
对欧洲九个使用老年精神量表（GMS）AGECAT的中心的数据进行了分析，以比较社区中65岁及以上老年人的诊断患病率。抑郁症的患病水平分别为：冰岛8.8%，利物浦10.0%；萨拉戈萨10.7%；都柏林11.9%；阿姆斯特丹12.0%；柏林16.5%；伦敦17.3%；维罗纳18.3%和慕尼黑23.6%。综合所有抑郁水平，确定了五个高分中心（阿姆斯特丹、柏林、慕尼黑、伦敦和维罗纳）和四个低分中心（都柏林、冰岛、利物浦、萨拉戈萨）。对所有13808名受试者进行的荟萃分析得出，抑郁症的平均患病水平为12.3%（95%置信区间11.8 - 12.9），女性为14.1%（95%置信区间13.5 - 14.8），男性为8.6%（95%置信区间7.9 - 9.3）。各中心的症状水平有所不同：阿姆斯特丹40%的研究总人群报告有抑郁情绪，而萨拉戈萨仅为26%。为纳入其他使用其他抑郁症识别方法的中心的研究，从GMS的12个项目中开发了EURO - D量表，并与其他量表和专家诊断进行了验证。出现了一个双因素解决方案，即“情感痛苦因素”和“动机因素”。EURO - D量表应用于14项基于人群的调查。与抑郁症患病率水平不同，抑郁评分往往随年龄增长而增加。在年龄、性别或婚姻状况无法解释的抑郁症水平上，各中心之间存在明显差异。这些数据表明，被定义为适合干预的抑郁症在欧洲老年人中很常见。几乎肯定正在错失有效治疗的机会。高分和低分中心之间的抑郁症状水平差异显著，这促使了本研究的下一阶段，即对欧洲的风险因素进行检查。
