按国家、性别、年龄和年份划分的抑郁障碍负担：来自 2010 年全球疾病负担研究的发现。
Burden of depressive disorders by country, sex, age, and year: findings from the global burden of disease study 2010.
机构信息
University of Queensland, School of Population Health, Herston, Queensland, Australia ; Queensland Centre for Mental Health Research, Wacol, Queensland, Australia.
出版信息
PLoS Med. 2013 Nov;10(11):e1001547. doi: 10.1371/journal.pmed.1001547. Epub 2013 Nov 5.
BACKGROUND
Depressive disorders were a leading cause of burden in the Global Burden of Disease (GBD) 1990 and 2000 studies. Here, we analyze the burden of depressive disorders in GBD 2010 and present severity proportions, burden by country, region, age, sex, and year, as well as burden of depressive disorders as a risk factor for suicide and ischemic heart disease.
METHODS AND FINDINGS
Burden was calculated for major depressive disorder (MDD) and dysthymia. A systematic review of epidemiological data was conducted. The data were pooled using a Bayesian meta-regression. Disability weights from population survey data quantified the severity of health loss from depressive disorders. These weights were used to calculate years lived with disability (YLDs) and disability adjusted life years (DALYs). Separate DALYs were estimated for suicide and ischemic heart disease attributable to depressive disorders. Depressive disorders were the second leading cause of YLDs in 2010. MDD accounted for 8.2% (5.9%-10.8%) of global YLDs and dysthymia for 1.4% (0.9%-2.0%). Depressive disorders were a leading cause of DALYs even though no mortality was attributed to them as the underlying cause. MDD accounted for 2.5% (1.9%-3.2%) of global DALYs and dysthymia for 0.5% (0.3%-0.6%). There was more regional variation in burden for MDD than for dysthymia; with higher estimates in females, and adults of working age. Whilst burden increased by 37.5% between 1990 and 2010, this was due to population growth and ageing. MDD explained 16 million suicide DALYs and almost 4 million ischemic heart disease DALYs. This attributable burden would increase the overall burden of depressive disorders from 3.0% (2.2%-3.8%) to 3.8% (3.0%-4.7%) of global DALYs.
CONCLUSIONS
GBD 2010 identified depressive disorders as a leading cause of burden. MDD was also a contributor of burden allocated to suicide and ischemic heart disease. These findings emphasize the importance of including depressive disorders as a public-health priority and implementing cost-effective interventions to reduce its burden. Please see later in the article for the Editors' Summary.
背景
在全球疾病负担研究 1990 年和 2000 年的研究中，抑郁障碍是导致负担的主要原因之一。在这里，我们分析了 2010 年全球疾病负担中抑郁障碍的负担，并介绍了严重程度比例、按国家、地区、年龄、性别和年份划分的负担，以及抑郁障碍作为自杀和缺血性心脏病风险因素的负担。
方法和发现
计算了重度抑郁症（MDD）和心境恶劣障碍的负担。进行了系统的流行病学数据综述。使用贝叶斯荟萃回归对数据进行了汇总。从人群调查数据中获得的残疾权重量化了抑郁障碍导致的健康损失的严重程度。这些权重用于计算残疾生命年（YLDs）和残疾调整生命年（DALYs）。分别估计了归因于抑郁障碍的自杀和缺血性心脏病的 DALY。2010 年，抑郁障碍是 YLDs 的第二大主要原因。MDD 占全球 YLDs 的 8.2%（5.9%-10.8%），心境恶劣障碍占 1.4%（0.9%-2.0%）。尽管抑郁障碍不是导致死亡的根本原因，但它仍是 DALYs 的主要原因。MDD 占全球 DALYs 的 2.5%（1.9%-3.2%），心境恶劣障碍占 0.5%（0.3%-0.6%）。MDD 的负担在区域间的变化大于心境恶劣障碍；女性和处于工作年龄的成年人的负担更高。虽然 1990 年至 2010 年期间负担增加了 37.5%，但这是由于人口增长和人口老龄化所致。MDD 导致 1600 万例自杀 DALY 和近 400 万例缺血性心脏病 DALY。这种归因于负担会使全球疾病负担中抑郁障碍的负担从 3.0%（2.2%-3.8%）增加到 3.8%（3.0%-4.7%）。
结论
全球疾病负担研究 2010 年确定抑郁障碍是导致负担的主要原因之一。MDD 也是分配给自杀和缺血性心脏病的负担的一个因素。这些发现强调了将抑郁障碍作为公共卫生重点，并实施具有成本效益的干预措施以减轻其负担的重要性。请稍后在文章中查看编辑摘要。
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