Sorvaniemi Marko, Alho Antti, Kesti Sini, Mattila Sanna, Moglia Pirjo, Pärssinen Hanna, Raittio Nina, Vattulainen Kimmo
Department of Psychiatry, University of Turku, and Senior Physician, Psychiatric Sector, Satakunta Hospital District, Finland.
Nord J Psychiatry. 2006;60(3):239-42. doi: 10.1080/08039480600583852.
There have been several reports of non-detection and undertreatment of major depression during the past decades. In this study, we investigated how accurately major depression was assessed, diagnosed and treated according to gold standards, and whether any trend could be found from 1989 to 2001 in Finland. In total, documents of 4447 patients were retrospectively checked at most four times to find the patients fulfilling the study criteria. Finally, 531 patients were included in the study. The major finding of the study was the improved diagnostic assessment of patients with major depression seen in psychiatric settings. However, a systematic and comprehensive approach in asking about and recording subtyping, severity and comorbidity of depression was insufficient. Another major finding of the study was the improved pharmacotherapy of patients with major depression. It seems to be relevant that problems in the quality of care for depression in psychiatric settings are now more likely to be related to suboptimal intensity and monitoring of treatment than to mere lack of treatment.
在过去几十年里，有几份关于重度抑郁症未被检测出以及治疗不足的报告。在本研究中，我们调查了根据金标准对重度抑郁症进行评估、诊断和治疗的准确程度，以及1989年至2001年期间在芬兰是否能发现任何趋势。总共对4447名患者的病历进行了最多四次回顾性检查，以找出符合研究标准的患者。最终，531名患者被纳入研究。该研究的主要发现是，在精神科环境中，对重度抑郁症患者的诊断评估有所改善。然而，在询问和记录抑郁症的亚型、严重程度和共病情况时，缺乏系统全面的方法。该研究的另一项主要发现是，重度抑郁症患者的药物治疗有所改善。精神科环境中抑郁症护理质量的问题现在似乎更多地与治疗强度不足和监测不力有关，而不仅仅是缺乏治疗，这一点似乎很重要。
