伊巴丹老年研究中尼日利亚老年人重度抑郁症的流行病学：一项基于社区的调查。
Epidemiology of major depressive disorder in elderly Nigerians in the Ibadan Study of Ageing: a community-based survey.
作者信息
Gureje Oye, Kola Lola, Afolabi Ebenezer
机构信息
College of Medicine, University of Ibadan, Ibadan, Nigeria.
出版信息
Lancet. 2007 Sep 15;370(9591):957-64. doi: 10.1016/S0140-6736(07)61446-9.
BACKGROUND
The growing populations of elderly people in sub-Saharan Africa are exposed to social changes with potential adverse effects on mental health. Our aim was to estimate the occurrence and effect of major depressive disorder in a large and representative community sample of elderly Africans.
METHODS
Face-to-face interviews with a representative sample of people aged 65 years and older (n=2152) were obtained by a multistage stratified sampling of households in the Yoruba-speaking areas of Nigeria (about 22% of the national population). Major depressive disorder was assessed with the WHO composite international diagnostic interview and diagnosed with the Diagnostic and Statistical Manual of Mental Disorders, fourth edition.
FINDINGS
Lifetime and 12-month prevalence estimates of major depressive disorder were 26.2% (95% CI 24.3-28.2) and 7.1% (5.9-8.3) respectively. Female sex (odds ratio [OR] 1.9) and increasing levels of urbanisation of residence (OR 1.4) were associated with this disorder. People with major depressive disorder had impaired quality of life and functioning in home, work, and social roles. Independent ratings of symptom severity confirmed the presence of clinically significant depression in 96.9% of those with diagnosis, and increasing symptom severity was associated with greater disability and poorer quality of life. Only about 37% of lifetime cases had received any treatment, and there was a mean delay of 5 years from onset of depression to receipt of first treatment. Low economic status (0.3) and rural residence (1.0) predicted no treatment.
INTERPRETATION
Major depressive disorder is common in elderly Nigerians and its occurrence is related to urbanisation. This disorder is a seriously disabling illness in this group but only a few sufferers have ever received treatment. Health-care services need to invest in effective treatment programmes for major depressive disorder.
背景
撒哈拉以南非洲地区老年人口不断增加，他们面临着社会变革，这些变革可能对心理健康产生不利影响。我们的目的是在一个具有代表性的非洲老年社区大样本中估计重度抑郁症的发生率及其影响。
方法
通过对尼日利亚约鲁巴语地区（约占全国人口的22%）家庭进行多阶段分层抽样，对65岁及以上的具有代表性样本（n = 2152）进行面对面访谈。使用世界卫生组织综合国际诊断访谈评估重度抑郁症，并根据《精神障碍诊断与统计手册》第四版进行诊断。
研究结果
重度抑郁症的终生患病率和12个月患病率估计分别为26.2%（95%可信区间24.3 - 28.2）和7.1%（5.9 - 8.3）。女性（优势比[OR] 1.9）和居住城市化程度的提高（OR 1.4）与该疾病相关。患有重度抑郁症的人在家庭、工作和社会角色方面的生活质量和功能受损。症状严重程度的独立评分证实，96.9%被诊断者存在临床上显著的抑郁症，症状严重程度的增加与更大的残疾和更差的生活质量相关。只有约37%的终生病例接受过任何治疗，从抑郁症发作到接受首次治疗的平均延迟时间为5年。低经济地位（0.3）和农村居住（1.0）预示未接受治疗。
解读
重度抑郁症在尼日利亚老年人中很常见，其发生与城市化有关。这种疾病在该群体中是一种严重致残的疾病，但只有少数患者接受过治疗。医疗服务需要投资于重度抑郁症的有效治疗方案。
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