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1990年至2003年间美国成年人口中抗抑郁药物使用量的增加。

Increase in antidepressant medication in the US adult population between 1990 and 2003.

作者信息

Mojtabai Ramin

机构信息

Department of Psychiatry, Beth Israel Medical Center, New York, NY 10010, USA.

出版信息

Psychother Psychosom. 2008;77(2):83-92. doi: 10.1159/000112885. Epub 2008 Jan 25.

Abstract

BACKGROUND

The rate of antidepressant treatment in the US has significantly increased in the past decade. There are, however, concerns about undertreatment among traditionally underserved groups and overtreatment in less severely ill individuals. This study examines trends in the prevalence of antidepressant drug treatment in two US general population surveys.

METHODS

The prevalence of antidepressant treatment within a 12-month period was compared in the US National Comorbidity Survey (1990-1992) and the National Comorbidity Survey-Replication (2001-2003). Variations in trends across groups were examined using bivariate and multivariate logistic regression models.

RESULTS

The rate of antidepressant drug treatment increased more than four times between early 1990s and early 2000s. The trend was similar across sociodemographic groups. Younger adults, men and racial/ethnic minorities continued to receive antidepressant treatment at a lower rate compared to middle-aged adults, women and non-Hispanic whites, respectively. The rate of antidepressant treatment increased more in the group of less severely ill individuals than in those with more severe psychopathology.

CONCLUSIONS

Sociodemographic disparities in antidepressant treatment persisted over the last decade in the US, lending support to concerns about undertreatment among traditionally underserved groups, whereas the greater increase in the rate of antidepressant treatment in the less severely ill group lends support to concerns about antidepressant overtreatment in this population.

摘要

背景

在过去十年中,美国抗抑郁药物治疗率显著上升。然而,人们担心传统上服务不足群体存在治疗不足的情况,以及病情较轻的个体存在过度治疗的问题。本研究在美国两项普通人群调查中考察了抗抑郁药物治疗患病率的趋势。

方法

在美国全国共病调查(1990 - 1992年)和全国共病调查复制版(2001 - 2003年)中比较了12个月内抗抑郁治疗的患病率。使用双变量和多变量逻辑回归模型研究不同群体间趋势的差异。

结果

从20世纪90年代初到21世纪初,抗抑郁药物治疗率增长了四倍多。社会人口统计学群体的趋势相似。与中年成年人、女性和非西班牙裔白人相比,年轻人、男性和种族/族裔少数群体接受抗抑郁治疗的比例仍然较低。病情较轻的个体组中抗抑郁治疗率的增长幅度大于精神病理学症状更严重的个体组。

结论

在美国,过去十年抗抑郁治疗中的社会人口统计学差异持续存在,这支持了对传统上服务不足群体治疗不足的担忧,而病情较轻群体中抗抑郁治疗率的更大增幅则支持了对该人群抗抑郁药物过度治疗的担忧。

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