Suija Kadri, Kalda Ruth, Maaroos Heidi-Ingrid
Department of Polyclinic and Family Medicine, University of Tartu, Puusepa 1a 50406, Tartu, Estonia.
BMC Fam Pract. 2009 Jun 1;10:38. doi: 10.1186/1471-2296-10-38.
High prevalence of depression among primary care patients has increased the need for more research in this field. The objectives of our study were to analyse how depressed patients evaluate their health; which co-morbid diseases are associated with depression; how depression influences the patients' consultation rate in family practice (FP); how disability is associated with depression; and how depression influences the patients' working ability.
A cross-sectional study, part of the PREDICT study. The study group was formed of 1094 consecutive patients from 23 FPs across Estonia, aged 18-75 years, attending a FP to consult the family doctor (FD). Occurrence of major depression during six months was estimated using the Depression Section of the Composite International Diagnostic Interview. The medical records of all patients were analysed concerning co-morbid diseases, number of visits to the FD, and disability. Every patient filled in questionnaires to assess health-related risk factors for depression, and the SF-12 Health Survey to assess functioning and the perception of health.
Depression was found in 230 (21%) of the patients. Depressed patients reported less accomplishment owing to emotional problems (OR 1.80; 95% CI 1.18-2.72), being less careful as usual (OR 1.81; 95% CI 1.26-2.60), and having pain that extremely interfered with their normal work (OR 2.50; 95% CI 1.33-4.70) in comparison with non-depressed patients. Also depressed patients were more days on sick-leave (OR 1.00; 95% CI 1.00-1.01) than non-depressed patients. However, analysis of the medical records did not indicate that depressed patients consulted the FD more or had more co-morbid diagnoses than the non-depressed patients.
Depressed patients may have low self-reported functioning due to emotional problems, pain, and their working ability may have decreased; however, the patients of both groups have an equal number of co-morbid diagnoses and their consultation rate is similar.
初级保健患者中抑郁症的高患病率增加了该领域更多研究的必要性。我们研究的目的是分析抑郁症患者如何评估自己的健康状况；哪些共病与抑郁症相关；抑郁症如何影响患者在家庭医疗（FP）中的就诊率；残疾与抑郁症如何关联；以及抑郁症如何影响患者的工作能力。
一项横断面研究，是PREDICT研究的一部分。研究组由来自爱沙尼亚23个家庭医疗诊所的1094名连续患者组成，年龄在18 - 75岁之间，前往家庭医疗诊所咨询家庭医生（FD）。使用综合国际诊断访谈中的抑郁症部分来估计六个月内重度抑郁症的发生情况。分析所有患者的病历以了解共病、就诊FD的次数和残疾情况。每位患者填写问卷以评估抑郁症的健康相关风险因素，并填写SF - 12健康调查以评估功能和健康感知。
在230名（21%）患者中发现了抑郁症。与非抑郁症患者相比，抑郁症患者因情绪问题报告成就较低（比值比[OR]1.80；95%置信区间[CI]1.18 - 2.72），不像往常那样小心（OR 1.81；95% CI 1.26 - 2.60），并且疼痛严重干扰其正常工作（OR 2.50；95% CI 1.33 - 4.70）。此外，抑郁症患者病假天数也比非抑郁症患者多（OR 1.00；95% CI 1.00 - 1.01）。然而，病历分析并未表明抑郁症患者比非抑郁症患者就诊FD的次数更多或共病诊断更多。
抑郁症患者可能因情绪问题和疼痛而自我报告的功能较低，其工作能力可能下降；然而，两组患者的共病诊断数量相同，就诊率相似。
