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[巴西前奴隶社区中的抑郁症:筛查及相关因素]

[Depression in former slave communities in Brazil: screening and associated factors].

作者信息

Barroso Sabrina Martins, Melo Ana Paula Souto, Guimarães Mark Drew Crosland

机构信息

Departamento de Psicologia, Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brasil,

Departamento de Medicina, Universidade Federal de São João del-Rei, Divinópolis, MG, Brasil.

出版信息

Rev Panam Salud Publica. 2014 Apr;35(4):256-63.

Abstract

OBJECTIVE

To assess the prevalence and the factors associated with positive screening for major depressive episode (MDE) in former slave communities in the state of Bahia, Brazil.

METHODS

In this population-based, cross-sectional study, 764 participants were randomly selected from five former slave communities in Vitória da Conquista, Bahia, Brazil. Depression was defined as a cutoff score of 10 or more points and the presence of five or more symptoms according to the Patient Health Questionnaire (PHQ-9). Poisson regression was used to assess prevalence ratios (PR), with a 95% confidence interval (95%CI).

RESULTS

Screening for MDE was positive in 12% of participants (95%CI: 10 - 14%), but only 2.3% reported a previous diagnosis. Depression was associated with self-reported poor or very poor health status (PR = 1.14; 95%CI: 1.04 - 1.26), chronic disease (PR = 1.08; 95%CI: 1.04 - 1.13), no physical activity (PR = 1.06; 95%CI: 1.01 - 1.11), and reasonable (PR = 1.07; 95%CI: 1.01 - 1.13) or poor access to health services (PR = 1.07; 95%CI: 1.02 - 1.12).

CONCLUSIONS

The prevalence of MDE in this population was similar to that of the general Brazilian population. The association between MDE and poor access to health services indicates a missed opportunity for early diagnosis. Public measures against social and health inequalities are necessary to ensure equity in these communities.

摘要

目的

评估巴西巴伊亚州前奴隶社区中重度抑郁发作(MDE)筛查呈阳性的患病率及相关因素。

方法

在这项基于人群的横断面研究中,从巴西巴伊亚州维多利亚达孔基斯塔的五个前奴隶社区中随机选取了764名参与者。根据患者健康问卷(PHQ - 9),抑郁被定义为截断分数为10分及以上且存在五种或更多症状。采用泊松回归评估患病率比(PR),并给出95%置信区间(95%CI)。

结果

12%的参与者MDE筛查呈阳性(95%CI:10 - 14%),但只有2.3%的人报告曾有过诊断。抑郁与自我报告的健康状况差或非常差(PR = 1.14;95%CI:1.04 - 1.26)、慢性病(PR = 1.08;95%CI:1.04 - 1.13)、无体育活动(PR = 1.06;95%CI:1.01 - 1.11)以及获得医疗服务的机会一般(PR = 1.07;95%CI:1.01 - 1.13)或较差(PR = 1.07;95%CI:1.02 - 1.12)相关。

结论

该人群中MDE的患病率与巴西普通人群相似。MDE与获得医疗服务机会差之间的关联表明存在早期诊断的错失良机。采取针对社会和健康不平等的公共措施对于确保这些社区的公平性是必要的。

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