McMahon Elaine M, Buszewicz Marta, Griffin Mark, Beecham Jennifer, Bonin Eva-Maria, Rost Felicitas, Walters Kate, King Michael
Research Department of Primary Care and Population Health, University College London, Upper Third Floor, Royal Free Hospital, Rowland Hill Street, London NW3 2PF, UK.
Int J Family Med. 2012;2012:316409. doi: 10.1155/2012/316409. Epub 2012 Jun 6.
Background. Major depression is often chronic or recurrent and is usually treated within primary care. Little is known about the associated morbidity and costs. Objectives. To determine socio-demographic characteristics of people with chronic or recurrent depression in primary care and associated morbidity, service use, and costs. Method. 558 participants were recruited from 42 GP practices in the UK. All participants had a history of chronic major depression, recurrent major depression, or dysthymia. Participants completed questionnaires including the BDI-II, Work and Social Adjustment Scale, Euroquol, and Client Service Receipt Inventory documenting use of primary care, mental health, and other services. Results. The sample was characterised by high levels of depression, functional impairment, and high service use and costs. The majority (74%) had been treated with an anti-depressant, while few had seen a counsellor (15%) or a psychologist (3%) in the preceding three months. The group with chronic major depression was most depressed and impaired with highest service use, whilst those with dysthymia were least depressed, impaired, and costly to support but still had high morbidity and associated costs. Conclusion. This is a patient group with very significant morbidity and high costs. Effective interventions to reduce both are required.
背景。重度抑郁症通常为慢性或复发性，通常在初级保健机构接受治疗。关于其相关的发病率和成本知之甚少。目标。确定初级保健中慢性或复发性抑郁症患者的社会人口学特征以及相关的发病率、服务利用情况和成本。方法。从英国42家全科医生诊所招募了558名参与者。所有参与者都有慢性重度抑郁症、复发性重度抑郁症或心境恶劣障碍的病史。参与者完成了包括贝克抑郁量表第二版（BDI-II）、工作和社会适应量表、欧洲五维健康量表以及客户服务收据清单在内的问卷，这些问卷记录了初级保健、心理健康和其他服务的使用情况。结果。该样本的特点是抑郁程度高、功能受损、服务利用率高且成本高。大多数人（74%）曾接受过抗抑郁药治疗，而在前三个月中，很少有人咨询过咨询师（15%）或心理学家（3%）。慢性重度抑郁症患者组抑郁程度最高、功能受损最严重，服务利用率也最高，而心境恶劣障碍患者组抑郁程度最低、功能受损最轻、支持成本最低，但仍有较高的发病率和相关成本。结论。这是一个发病率非常高且成本高昂的患者群体。需要有效的干预措施来降低发病率和成本。
