Mogga Souci, Prince Martin, Alem Atalay, Kebede Derege, Stewart Robert, Glozier Nick, Hotopf Matthew
Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK.
Br J Psychiatry. 2006 Sep;189:241-6. doi: 10.1192/bjp.bp.105.013417.
The outcome and impact of major depression in developing countries are not clear.
To describe the outcome of major depression and compare the disability and patterns of service use among different outcome groups.
In a case cohort study, nested within a population-based survey of 68,000 participants using the Composite International Diagnostic Interview (CIDI), 300 participants were randomly selected from those with current major depression and 300 from those with no lifetime history. Participants were re-interviewed after 18-62 months to ascertain current diagnosis, psychological symptoms, disability and use of health services.
Of participants with major depression at baseline 26% also met criteria for major depression at follow up. Mortality ratio standardised for age and gender was 3.55 (95% C11.97 to 6.39). All indices of measure of disability were significantly higher in the persistently depressed group compared with the completely recovered group. Participants who had recovered partially resembled participants with persistent depression. Two-thirds of those with persistent depression had not sought any help.
Major depression was associated with mortality and disability. Those with residual symptoms remained disabled. Help-seeking was unusual.
发展中国家重度抑郁症的结局和影响尚不清楚。
描述重度抑郁症的结局，并比较不同结局组之间的残疾情况和服务利用模式。
在一项病例队列研究中，该研究嵌套于一项对68000名参与者进行的基于人群的调查中，使用复合国际诊断访谈（CIDI），从当前患有重度抑郁症的参与者中随机选取300人，从无终生病史的参与者中随机选取300人。在18 - 62个月后对参与者进行再次访谈，以确定当前诊断、心理症状、残疾情况和卫生服务利用情况。
基线时患有重度抑郁症的参与者中，26%在随访时也符合重度抑郁症的标准。年龄和性别标准化死亡率为3.55（95%CI 1.97至6.39）。与完全康复组相比，持续抑郁组的所有残疾测量指标均显著更高。部分康复的参与者与持续抑郁的参与者相似。三分之二持续抑郁的人未寻求任何帮助。
重度抑郁症与死亡率和残疾有关。有残留症状的人仍然残疾。寻求帮助的情况并不常见。
