Feightner J W, Worrall G
Department of Family Medicine, McMaster University, Hamilton, Ont.
CMAJ. 1990 Jun 1;142(11):1215-20.
The overall prevalence of depression is from 3.5% to 27%. The burden of suffering is high and includes death through suicide. In most cases treatment is effective, but important episodes of depression are being missed. To determine whether a brief, systematic assessment for the early detection of depression should be part of the periodic health examination we searched MEDLINE and the Science Citation Index for randomized controlled trials that evaluated the effectiveness of early detection of depression with a questionnaire. Seven instruments met our quality criteria; the Beck Depression Inventory, the Center for Epidemiologic Studies Depression Scale, the Zung Self-Assessment Depression Scale, the General Health Questionnaire, the Hopkins Symptom Checklist, the Mental Health Inventory and the Hospital Anxiety and Depression Scale. The four randomized controlled trials failed to provide adequate evidence of the benefit of routine screening. Early detection is difficult because of depression's natural history, the role of symptoms, the cultural diversity of Canada and how detection instruments have been developed. Depression deserves careful attention from primary care physicians; however, further research and development is required before the widespread routine use of any detection test can be recommended.
抑郁症的总体患病率为3.5%至27%。痛苦负担沉重，包括自杀死亡。在大多数情况下，治疗是有效的，但重要的抑郁发作却被漏诊。为了确定对抑郁症进行早期检测的简短、系统评估是否应成为定期健康检查的一部分，我们检索了MEDLINE和科学引文索引，以查找评估用问卷进行抑郁症早期检测有效性的随机对照试验。七份测评工具符合我们的质量标准；分别是贝克抑郁量表、流行病学研究中心抑郁量表、zung自评抑郁量表、一般健康问卷、霍普金斯症状清单、心理健康量表和医院焦虑抑郁量表。四项随机对照试验未能提供充分证据证明常规筛查的益处。由于抑郁症的自然病程、症状的作用、加拿大的文化多样性以及检测工具的开发方式，早期检测存在困难。抑郁症值得初级保健医生密切关注；然而，在推荐广泛常规使用任何检测方法之前，还需要进一步的研究和开发。
