Patten Scott B, Williams Jeanne V A, Lavorato Dina H, Eliasziw Michael
Department of Community Health Sciences, University of Calgary, Calgary, Canada.
BMC Public Health. 2009 Mar 25;9:87. doi: 10.1186/1471-2458-9-87.
The objective of this study was to determine whether major depressive episodes (MDE) contribute to a lower rate of participation in three prevention activities: blood pressure checks, mammograms and Pap tests.
The data source for this study was the Canadian National Population Health Survey (NPHS), a longitudinal study that started in 1994 and has subsequently re-interviewed its participants every two years. The NPHS included a short form version of the Composite International Diagnostic Interview (CIDI-SF) to assess past year MDE and also collected data on participation in preventive activities. Initially, we examined whether respondents with MDE in a particular year were less likely to participate in screening during that same year. In order to assess whether MDE negatively altered the pattern of participation, those successfully screened at the baseline interview in 1994 were identified and divided into cohorts depending on their MDE status. Proportional hazard models were used to quantify the effect of MDE on subsequent participation in screening.
No effect of MDE on participation in the three preventive activities was identified either in the cross-sectional or longitudinal analysis. Adjustment for a set of relevant covariates did not alter this result.
Whereas MDE might be expected to reduce the frequency of participation in screening activities, no evidence for this was found in the current analysis. Since people with MDE may contact the health system more frequently, this may offset any tendency of the illness itself to reduce participation in screening.
本研究的目的是确定重度抑郁发作（MDE）是否会导致参与三项预防活动（血压检查、乳房X光检查和巴氏试验）的比率降低。
本研究的数据来源是加拿大国家人口健康调查（NPHS），这是一项始于1994年的纵向研究，随后每两年对参与者进行一次重新访谈。NPHS包括综合国际诊断访谈的简版（CIDI-SF），用于评估过去一年的MDE，同时还收集了参与预防活动的数据。最初，我们研究了某一年患有MDE的受访者在同一年参与筛查的可能性是否较低。为了评估MDE是否对参与模式产生负面影响，我们确定了在1994年基线访谈中成功接受筛查的受访者，并根据他们的MDE状态将其分为不同队列。使用比例风险模型来量化MDE对后续参与筛查的影响。
在横断面分析或纵向分析中，均未发现MDE对参与三项预防活动有影响。对一组相关协变量进行调整并没有改变这一结果。
虽然预计MDE可能会降低参与筛查活动的频率，但在当前分析中未发现相关证据。由于患有MDE的人可能更频繁地与医疗系统接触，这可能会抵消疾病本身导致参与筛查减少的任何趋势。
