School of health science, Dilla University, Dilla, Ethiopia.
Int J Ment Health Syst. 2012 Oct 25;6(1):23. doi: 10.1186/1752-4458-6-23.
Integrating mental health into primarily health care and studying risk for mental health particularly depression needs assessment of different factors including those that impede diagnosis and treatment of mental disorders. But so far the numbers of literature for local context to analyze risk factors for depression and its treatment are scare. The objective of this study was to assess risk factors and health service attendance for depression among adults, in Ethiopia.
For this analysis, data from the Ethiopian National health survey was used. The Ethiopian national health survey studied 4,925 adults aged 18 years and older to obtain among other things, data on depression episodes, socio-demographic, chronic diseases, life style factors and treatment receiving for depression episodes in the past twelve months using questionnaire from world health organization (WHO). Prevalence of Depression in respondents based on ICD-10 criteria was estimated and logistic regression analysis was used to identify risk factors for depression and treatment receiving.
The prevalence of depressive episode was 9.1% (95% CI: 8.39-9.90). In a Univariate analysis, residence, age, marital status, educational status, number of diagnosed chronic non communicable diseases (heart diseases, diabetic mellitus and arthritis) and alcohol drinking status were associated with depression. After full adjustment for possible confounding, odds ratios for depression were significantly higher only for older age, divorced and widowed, number of diagnosed chronic non communicable diseases and alcohol drinking status. The proportion of attending health service among those with depression episodes was 22.9%. After full control for all socio-demographic variables the only predictor variable was educational status, being in grade 5-8 had a higher odds (OR=2.6, 95% CI: 1.23-5.43) and 9-12 grade (OR=1.8 95% CI: 1.45-6.12) of attending service for depressive episodes.
Age, marital status, number of diagnosed chronic non communicable diseases and alcohol consumption were the most important risk factors for depressive episodes. Generally there was lower use of health service for depressive episodes and low educational status was found to be barriers for service use. There is a need to formulate policy for mental health and training of primary health care workers in mental health to early identify and treat cases with depression episodes, so as to decrease prevalence of depression episodes and to improve accessibility of service use.
将心理健康纳入主要医疗保健服务,并研究心理健康风险,尤其是抑郁风险,需要评估包括阻碍精神障碍诊断和治疗的因素在内的不同因素。但到目前为止,用于分析抑郁风险及其治疗的当地情况的文献数量很少。本研究旨在评估埃塞俄比亚成年人的抑郁风险因素和卫生服务利用情况。
本分析使用了埃塞俄比亚国家健康调查的数据。埃塞俄比亚国家健康调查研究了 4925 名 18 岁及以上的成年人,以获得包括抑郁发作、社会人口统计学、慢性病、生活方式因素以及过去 12 个月内接受抑郁发作治疗等方面的数据。使用世界卫生组织(WHO)的问卷,根据 ICD-10 标准,估计了受访者中抑郁的患病率,并进行逻辑回归分析,以确定抑郁的风险因素和治疗情况。
抑郁发作的患病率为 9.1%(95%CI:8.39-9.90)。在单变量分析中,居住地、年龄、婚姻状况、教育程度、诊断出的慢性非传染性疾病(心脏病、糖尿病和关节炎)数量以及饮酒状况与抑郁有关。在充分调整可能的混杂因素后,仅年龄较大、离婚和丧偶、诊断出的慢性非传染性疾病数量和饮酒状况与抑郁的比值比显著升高。有抑郁发作的人就诊卫生服务的比例为 22.9%。在充分控制所有社会人口统计学变量后,唯一的预测变量是教育程度,就读 5-8 年级的人(OR=2.6,95%CI:1.23-5.43)和 9-12 年级(OR=1.8,95%CI:1.45-6.12)更有可能就诊于治疗抑郁发作。
年龄、婚姻状况、诊断出的慢性非传染性疾病数量和饮酒是抑郁发作的最重要风险因素。一般来说,抑郁发作的卫生服务利用率较低,发现低教育程度是服务利用的障碍。需要制定精神卫生政策,并培训初级卫生保健工作者进行精神卫生,以便及早发现和治疗抑郁发作病例,从而降低抑郁发作的患病率,并提高服务利用的可及性。