Goldney Robert D, Fisher Laura J, Grande Eleonora Dal, Taylor Anne W, Hawthorne Graeme
Adelaide Clinic, 33 Park Terrace, Gilberton, SA 5081, Australia.
Aust N Z J Psychiatry. 2007 Jan;41(1):38-53. doi: 10.1080/00048670601050465.
To identify changes in depression, its management and associated excess costs, between 1998 and 2004 in South Australia.
A face-to-face Health Omnibus Survey was conducted in 2004 among 3015 randomly selected participants aged 15 years and over, who were a random and representative sample of the South Australian population, and this was compared with a survey conducted in 1998 that used the same methodology. The main outcome measures were prevalence of depression detected by the Mood Module of the Primary Care Evaluation of Mental Disorders (PRIME-MD); use of health services; health-related quality of life assessed by the Assessment of Quality of Life; estimates of excess costs and demographic data.
There was no significant change in the overall prevalence of depression, although there was a significant decrease in respondents with other depressions, and a non-significant increase in those with major depression. No significant differences in the mean number of PRIME-MD depression symptoms were reported. Greater use of predominantly non-medical treatment services and antidepressants were reported by both those with depression and those without depression. There was a marked increase in the associated excess costs of depression.
There has been no significant improvement in the prevalence of depression and its associated morbidity and financial burden in the South Australian community between 1998 and 2004, despite a number of professional and community education programmes. It is possible that without these efforts and the increased treatment reported on in this survey, there may have been an increase in the prevalence of depression and an even greater financial burden. However, it is also possible that community services for the provision of treatment for depression have not been able to implement research strategies that have been demonstrated to be effective.
确定1998年至2004年间南澳大利亚州抑郁症的变化情况、其治疗手段以及相关额外费用。
2004年对3015名随机抽取的15岁及以上参与者进行了面对面的综合健康调查，这些参与者是南澳大利亚州人口的随机且具有代表性的样本，并将其与1998年采用相同方法进行的调查相比较。主要结局指标包括通过精神障碍初级保健评估（PRIME-MD）情绪模块检测出的抑郁症患病率；卫生服务的使用情况；通过生活质量评估来衡量的与健康相关的生活质量；额外费用估计以及人口统计学数据。
抑郁症的总体患病率没有显著变化，尽管其他类型抑郁症的受访者人数显著减少，而重度抑郁症患者人数有不显著的增加。报告的PRIME-MD抑郁症症状平均数量没有显著差异。抑郁症患者和非抑郁症患者都报告更多地使用了主要是非医疗治疗服务和抗抑郁药。抑郁症相关的额外费用显著增加。
尽管开展了一些专业和社区教育项目，但199&年至2004年间，南澳大利亚州社区中抑郁症的患病率及其相关发病率和经济负担并没有显著改善。如果没有这些努力以及本调查中报告的治疗增加情况，抑郁症患病率可能会上升，经济负担可能会更重。然而，也有可能提供抑郁症治疗的社区服务未能实施已被证明有效的研究策略。
