Roskar Saska, Podlesek Anja, Zorko Maja, Tavcar Rok, Dernovsek Mojca Zvezdana, Groleger Urban, Mirjanic Milan, Konec Nusa, Janet Evgen, Marusic Andrej
Institute of Public Health of theRepublic of Slovenia, Ljubljana, Slovenia.
Croat Med J. 2010 Jun;51(3):237-42. doi: 10.3325/cmj.2010.51.237.
To implement and evaluate an educational program for primary care physicians on recognition and treatment of depression and suicide prevention.
The study was conducted in 3 Slovenian neighboring regions (Celje, Ravne na Koroskem, and Podravska) with similar suicide rates and other health indicators. All primary care physicians from Celje (N=155) and Ravne na Koroskem (N=35) were invited to participate in the educational program on depression treatment and suicide risk recognition. From January to March 2003, approximately half of them (82 out of 190; educational group) attended the program, whereas the other half (108 out of 190; control group 1) and physicians from the Podravska region (N=164; control group 2) did not attend the program. The prescription rates of antidepressants and anxiolytics before and after the intervention were compared between the studied regions. Also, suicide rates three-years before and after the intervention were compared.
From 2002 to 2003, there was a 2.33-fold increase in the rate of antidepressant prescriptions in the educational group (P<0.05) and only 1.28-fold (P<0.05) and 1.34-fold (P<0.05) increase in control groups 1 and 2, respectively. However, the 12% decrease in suicide rate in the intervention regions was not significantly greater than the 4% decrease in the non-intervention region (P>0.05).
Our training program was beneficial for primary care physicians' ability to recognize and manage depression. However, there was no significant decrease in local suicide rates.
实施并评估一项针对初级保健医生的关于抑郁症识别与治疗及自杀预防的教育项目。
该研究在斯洛文尼亚3个相邻地区(采列、拉夫尼-纳-科罗斯克和波德拉夫斯卡)进行,这些地区自杀率及其他健康指标相似。邀请了采列(N = 155)和拉夫尼-纳-科罗斯克(N = 35)的所有初级保健医生参加关于抑郁症治疗和自杀风险识别的教育项目。2003年1月至3月,约一半医生(190名中的82名;教育组)参加了该项目,而另一半(190名中的108名;对照组1)以及波德拉夫斯卡地区的医生(N = 164;对照组2)未参加该项目。比较了研究地区干预前后抗抑郁药和抗焦虑药的处方率。此外,还比较了干预前后三年的自杀率。
从2002年到2003年,教育组抗抑郁药处方率增长了2.33倍(P < 0.05),对照组1和对照组2分别仅增长了1.28倍(P < 0.05)和1.34倍(P < 0.05)。然而,干预地区自杀率下降12%并不比非干预地区下降4%显著更大(P > 0.05)。
我们的培训项目有利于提高初级保健医生识别和管理抑郁症的能力。然而,当地自杀率并未显著下降。