Hengartner Michael P, Angst Felix, Ajdacic-Gross Vladeta, Rössler Wulf, Angst Jules
Department of Applied Psychology, Zurich University of Applied Sciences, Zurich, Switzerland.
Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry, University of Zurich, Lenggstrasse 31, P.O. Box 1931, 8032, Zurich, Switzerland.
Eur Arch Psychiatry Clin Neurosci. 2016 Mar;266(2):173-80. doi: 10.1007/s00406-015-0646-5. Epub 2015 Oct 23.
The aim of this study was to determine prevalence rates of several components of depression (unipolar and bipolar major, minor, recurrent brief depression, and dysthymia) and to identify covariates of treatment. We analysed a representative population-based, long-term prospective cohort study from age 20 to 50. Across the seven semi-structured interviews, generalized estimating equations examined the associations between diagnoses and treatment status during the course. The results show that the mean annual treatment rate across 30 years in persons with MDE was 39.2%. The weighted treatment prevalence for any depressive disorder was 23.4% (15.7% for MDE, 4.3% for minor depressive disorders and 3.4% for non-diagnosed subjects). Persons were more likely to seek treatment as they grew older. Women with MDE had triple the treatment prevalence of men (23.8 vs. 7.4%). Variables of distress/suffering under depression (OR 1.36-1.52) and the number of diagnostic depressive symptoms (OR 1.47) were statistically significant predictors of treatment, as were episode duration (OR 2.21) and various variables assessing impairment due to depression (OR 4.65-8.02). In conclusion, only a minority of persons with depressive disorders seek professional treatment in the year of disorder onset. Women and subjects suffering from high levels of depressive symptoms, frequent episodes, long episode duration and consecutive high distress and impairment were more likely to seek treatment.
本研究的目的是确定抑郁症的几个组成部分(单相和双相重度、轻度、复发性短暂抑郁症和心境恶劣)的患病率,并确定治疗的协变量。我们分析了一项具有代表性的基于人群的长期前瞻性队列研究,研究对象年龄在20至50岁之间。在七次半结构化访谈中,广义估计方程检验了病程中诊断与治疗状态之间的关联。结果显示,患有重度抑郁症(MDE)的人在30年中的年均治疗率为39.2%。任何抑郁症的加权治疗患病率为23.4%(MDE为15.7%,轻度抑郁症为4.3%,未诊断者为3.4%)。随着年龄的增长,人们寻求治疗的可能性更大。患有MDE的女性的治疗患病率是男性的三倍(23.8%对7.4%)。抑郁症下的痛苦/折磨变量(比值比1.36 - 1.52)和诊断性抑郁症状的数量(比值比1.47)是治疗的统计学显著预测因素,发作持续时间(比值比2.21)以及评估抑郁症所致损害的各种变量(比值比4.65 - 8.02)也是如此。总之,在疾病发作当年,只有少数抑郁症患者寻求专业治疗。女性以及患有高水平抑郁症状、频繁发作、发作持续时间长且持续高度痛苦和功能受损的患者更有可能寻求治疗。