重度抑郁症的流行病学建模：用于 2010 年全球疾病负担研究。

The epidemiological modelling of major depressive disorder: application for the Global Burden of Disease Study 2010.

机构信息

University of Queensland, School of Population Health, Herston, Queensland, Australia.

出版信息

PLoS One. 2013 Jul 29;8(7):e69637. doi: 10.1371/journal.pone.0069637. Print 2013.

BACKGROUND

Although the detrimental impact of major depressive disorder (MDD) at the individual level has been described, its global epidemiology remains unclear given limitations in the data. Here we present the modelled epidemiological profile of MDD dealing with heterogeneity in the data, enforcing internal consistency between epidemiological parameters and making estimates for world regions with no empirical data. These estimates were used to quantify the burden of MDD for the Global Burden of Disease Study 2010 (GBD 2010).

METHOD

Analyses drew on data from our existing literature review of the epidemiology of MDD. DisMod-MR, the latest version of the generic disease modelling system redesigned as a Bayesian meta-regression tool, derived prevalence by age, year and sex for 21 regions. Prior epidemiological knowledge, study- and country-level covariates adjusted sub-optimal raw data.

RESULTS

There were over 298 million cases of MDD globally at any point in time in 2010, with the highest proportion of cases occurring between 25 and 34 years. Global point prevalence was very similar across time (4.4% (95% uncertainty: 4.2-4.7%) in 1990, 4.4% (4.1-4.7%) in 2005 and 2010), but higher in females (5.5% (5.0-6.0%) compared to males (3.2% (3.0-3.6%) in 2010. Regions in conflict had higher prevalence than those with no conflict. The annual incidence of an episode of MDD followed a similar age and regional pattern to prevalence but was about one and a half times higher, consistent with an average duration of 37.7 weeks.

CONCLUSION

We were able to integrate available data, including those from high quality surveys and sub-optimal studies, into a model adjusting for known methodological sources of heterogeneity. We were also able to estimate the epidemiology of MDD in regions with no available data. This informed GBD 2010 and the public health field, with a clearer understanding of the global distribution of MDD.

背景

尽管重度抑郁症（MDD）对个体层面的不利影响已被描述，但由于数据的局限性，其全球流行病学仍不清楚。在这里，我们展示了 MDD 的建模流行病学特征，处理了数据中的异质性，在流行病学参数之间保持了内部一致性，并对没有经验数据的世界区域进行了估计。这些估计用于量化 2010 年全球疾病负担研究（GBD 2010）中 MDD 的负担。

方法

分析利用了我们现有的 MDD 流行病学文献综述数据。DisMod-MR 是通用疾病建模系统的最新版本，重新设计为贝叶斯元回归工具，按年龄、年份和性别为 21 个区域推导了患病率。先前的流行病学知识、研究和国家层面的协变量调整了原始数据的不足。

结果

2010 年任何时候，全球有超过 2.98 亿例 MDD 病例，其中病例比例最高的是 25 至 34 岁之间。全球时点患病率在不同时间非常相似（1990 年为 4.4%（95%置信区间：4.2-4.7%），2005 年和 2010 年为 4.4%（4.1-4.7%）），但女性高于男性（2010 年女性为 5.5%（5.0-6.0%），男性为 3.2%（3.0-3.6%））。冲突地区的患病率高于无冲突地区。MDD 发作的年发病率与患病率遵循相似的年龄和区域模式，但要高 1.5 倍左右，这与平均 37.7 周的持续时间一致。