Wedegärtner Felix, Arnhold-Kerri Sonja, Sittaro Nicola-Alexander, Lohse Ralf, Dietrich Detlef E, Bleich Stefan, Geyer Siegfried
Zentrum für seelische Gesundheit, Klinik für Psychiatrie, Sozialpsychiatrie und Psychotherapie, Medizinische Hochschule Hannover, Hannover, Germany.
Psychiatr Prax. 2011 Apr;38(3):135-41. doi: 10.1055/s-0030-1265956. Epub 2011 Apr 1.
It was the aim of this study to estimate effects of depression on permanent disability and death in a statutory health insurance population.
Data from 128,001 clients were used with a mean follow up of 6.4 years. Excess risks were calculated with Cox regression models adjusted for age, gender, education and job classification.
Outpatient treatment for depression was associated with an elevated relative risk for permanent disability, but inpatient treatment even more so. Life table analysis suggests higher risks of early retirement for males who get ill early in life. Depression treated solely in an outpatient setting may be associated with lower mortality early in life, but this was only significant for women.
Outpatient treatment should include an emphasis on occupational functioning, but also a gender-specific approach is needed.
本研究旨在评估抑郁症对法定医疗保险人群永久性残疾和死亡的影响。
使用了128,001名客户的数据，平均随访时间为6.4年。采用Cox回归模型计算超额风险，并对年龄、性别、教育程度和职业分类进行了调整。
抑郁症门诊治疗与永久性残疾的相对风险升高有关，但住院治疗的相关性更强。生命表分析表明，早年患病的男性提前退休的风险更高。仅在门诊治疗的抑郁症可能与早年较低的死亡率有关，但这仅对女性有显著意义。
门诊治疗应强调职业功能，同时也需要针对性别的方法。
