Milanović Sanja Musić, Erjavec Katja, Poljičanin Tamara, Vrabec Božena, Brečić Petrana
Andrija Štampar School of Public Health, School of Medicine, University of Zagreb, Zagreb, Croatia.
Psychiatr Danub. 2015 Mar;27(1):31-7.
Depression is a growing public health problem still under-recognised in primary care settings. By focusing primarily on somatic complaints and diseases, general practitioners often fail to identify an underlying mental disorder. The aim of this study was to assess the prevalence of patients with unrecognised depression symptoms in general practice and identify associated socio-demographic factors.
The study included 769 patients without previous psychiatric disorder who attended their primary care physicians in the Health Centre Zagreb - Zapad in January 2011. Data on patients' age, sex, level of education, marital and employment status were collected. All participants completed The Zung Self-Rating Depression Scale.
Among the 25.5% of participants whose Zung score was outside the normal range, 19.38% were mildly, 4.64% moderately, and 0.91% severely depressed. Statistically significant differences were observed among groups defined according to level of education, employment and marital status (p<0.001). Lower Zung scores were found in individuals with a higher level of education, who were unmarried, employed or still undergoing education. Multivariate logistic regression model revealed that older age (p<0.001), unemployment (p=0.001) or unmarried status (p=0.025) were significant predictors of depression symptoms.
The study revealed a high prevalence of depression symptoms among primary care patients who had not been previously suspected to have any psychiatric co-morbidity. Awareness of depression symptoms and disorders should be raised among general practitioners, focusing on older, unemployed and unmarried people.
抑郁症是一个日益严重的公共卫生问题,在基层医疗环境中仍未得到充分认识。由于全科医生主要关注躯体症状和疾病,他们常常无法识别潜在的精神障碍。本研究的目的是评估基层医疗中未被识别出的抑郁症症状患者的患病率,并确定相关的社会人口学因素。
该研究纳入了2011年1月在萨格勒布-扎帕德健康中心就诊于其初级保健医生的769例既往无精神疾病的患者。收集了患者的年龄、性别、教育程度、婚姻和就业状况数据。所有参与者均完成了zung自评抑郁量表。
在zung评分超出正常范围的25.5%的参与者中,19.38%为轻度抑郁,4.64%为中度抑郁,0.91%为重度抑郁。根据教育程度、就业和婚姻状况定义的组间观察到统计学上的显著差异(p<0.001)。教育程度较高、未婚、就业或仍在接受教育的个体zung评分较低。多因素逻辑回归模型显示,年龄较大(p<0.001)、失业(p=0.001)或未婚状态(p=0.025)是抑郁症状的显著预测因素。
该研究揭示了在先前未怀疑有任何精神疾病共病的基层医疗患者中,抑郁症状的高患病率。应提高全科医生对抑郁症状和障碍的认识,重点关注老年人、失业者和未婚者。