Bramesfeld A, Schwartz F W
Abteilung für Epidemiologie, Sozialmedizin und Gesundheitssystemforschung, Medizinische Hochschule Hannover.
Gesundheitswesen. 2006 Aug-Sep;68(8-9):508-16. doi: 10.1055/s-2006-927067.
When considering measures to decrease the burden of disease that is caused by depression, the depressive diseases of adolescents and young adults are of increasing interest. The prevalence in this group is high and an increase in prevalence has to be considered. The prognosis for juvenile depression is particularly bad. This review discusses the potentials to influence the burden of disease through interventions such as therapy, indicated, selective and universal prevention and health promotion for adolescents and young adults. The most impact can thereby be expected from an effective treatment of depression and other mental diseases that have high co-morbidity with depression. There is some evidence for the effectiveness of preventive interventions for depression, however, most approaches currently seem to be unsuitable for wide implementation in the population. However, as open measures, they can offer individual benefit. Health promotion that focuses on political, living and societal conditions should be directed at the family. Policy measures that improve the living conditions of parents also promote the mental health of children. Finally, the discussion about the burden of disease that is caused by depression should be held by considering current societal norms. In this context, it is of special interest as to how much depression and how much loss of function should be still considered as normal and not eligible for intervention.
在考虑减轻抑郁症所致疾病负担的措施时，青少年和青年的抑郁症越来越受到关注。该群体中的患病率很高，且患病率有上升趋势。青少年抑郁症的预后尤其糟糕。本综述讨论了通过治疗、针对性预防、选择性预防和普遍预防以及针对青少年和青年的健康促进等干预措施来影响疾病负担的可能性。因此，对抑郁症及其他与抑郁症共病率高的精神疾病进行有效治疗有望产生最大影响。有证据表明抑郁症预防干预措施是有效的，然而，目前大多数方法似乎不适用于在人群中广泛实施。不过，作为开放性措施，它们可以带来个体益处。关注政治、生活和社会状况的健康促进应以家庭为导向。改善父母生活条件的政策措施也能促进儿童的心理健康。最后，关于抑郁症所致疾病负担的讨论应结合当前社会规范进行。在这种背景下，特别值得关注的是，多少抑郁症及功能丧失仍应被视为正常而无需干预。
