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在美国有或没有抑郁和焦虑症的社区居住拉丁裔全国代表性样本中抗抑郁药的使用情况。

Antidepressant use in a nationally representative sample of community-dwelling US Latinos with and without depressive and anxiety disorders.

作者信息

González Hector M, Tarraf Wassim, West Brady T, Croghan Thomas W, Bowen Mary E, Cao Zhun, Alegría Margarita

机构信息

Institute of Gerontology, Wayne State University, Detroit, Michigan 48202, USA.

出版信息

Depress Anxiety. 2009;26(7):674-81. doi: 10.1002/da.20561.

Abstract

BACKGROUND

Antidepressant drugs are among the most widely prescribed drugs in the United States; however, little is known about their use among major ethnic minority groups.

METHOD

Collaborative Psychiatric Epidemiology Surveys (CPES) data were analyzed to calculate nationally representative estimates of Latino and non-Latino White adults antidepressant use.

SETTING

The 48 coterminous United States was the setting.

PARTICIPANTS

Household residents aged 18 years and older (N=9,250).

MAIN OUTCOME

Past year antidepressant use.

RESULTS

Compared to non-Latino Whites, few Latinos, primarily Mexican Americans, with 12-month depressive and/or anxiety disorders reported past year antidepressant use. Mexican Americans (OR=0.48; 95%CI=0.30-0.77) had significantly lower odds of use compared to non-Latino Whites, which were largely unaffected by factors associated with access to care. Over half of antidepressant use was by respondents not meeting 12-month criteria for depressive or anxiety disorders. Lifetime depressive and anxiety disorders explained another 21% of past year antidepressant use, leaving another 31% of drug use unexplained.

DISCUSSION

We found a disparity in antidepressant use for Mexican Americans compared to non-Latino Whites that was not accounted for by differences in need and factors associated with access to care. About one third of antidepressant use was by respondents not meeting criteria for depressive or anxiety disorders. Our findings underscore the importance of disaggregating Latino ethnic groups. Additional work is needed to understand the medical and economic value of antidepressant use beyond their primary clinical targets.

摘要

背景

抗抑郁药物是美国处方量最大的药物之一;然而,对于主要少数族裔群体使用这些药物的情况却知之甚少。

方法

分析协作精神疾病流行病学调查(CPES)数据,以计算拉丁裔和非拉丁裔白人成年人使用抗抑郁药物的全国代表性估计值。

地点

美国本土48个州。

参与者

18岁及以上的家庭居民(N = 9250)。

主要结果

过去一年使用抗抑郁药物的情况。

结果

与非拉丁裔白人相比,很少有患有12个月抑郁和/或焦虑症的拉丁裔,主要是墨西哥裔美国人报告过去一年使用过抗抑郁药物。与非拉丁裔白人相比,墨西哥裔美国人使用抗抑郁药物的几率显著更低(OR = 0.48;95%CI = 0.30 - 0.77),这在很大程度上不受与获得医疗服务相关因素的影响。超过一半的抗抑郁药物使用者不符合抑郁或焦虑症的12个月诊断标准。终生抑郁和焦虑症解释了过去一年抗抑郁药物使用情况中的另外21%,其余31%药物使用情况无法解释。

讨论

我们发现墨西哥裔美国人与非拉丁裔白人在抗抑郁药物使用方面存在差异,这种差异无法通过需求差异以及与获得医疗服务相关的因素来解释。约三分之一的抗抑郁药物使用者不符合抑郁或焦虑症的诊断标准。我们的研究结果强调了区分拉丁裔族群的重要性。需要开展更多工作来了解抗抑郁药物在其主要临床靶点之外的医疗和经济价值。

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