一家综合医院中埃塞俄比亚城市成年门诊患者的重度抑郁症和自杀行为
Major depressive disorder and suicidal behavior among urban dwelling Ethiopian adult outpatients at a general hospital.
作者信息
Whittier Anjalene B, Gelaye Bizu, Deyessa Negussie, Bahretibeb Yonas, Kelkile Teshome Shibre, Berhane Yemane, Williams Michelle A
机构信息
Department of Psychiatry, University of Cambridge, Cambridge, UK.
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
出版信息
J Affect Disord. 2016 Jun;197:58-65. doi: 10.1016/j.jad.2016.02.052. Epub 2016 Feb 27.
BACKGROUND
We sought to evaluate the prevalence and correlates of major depressive disorder (MDD) and suicidal behavior among urban dwelling Ethiopian adults.
METHODS
This was a cross-sectional study of 1097 outpatient adults (≥18 years of age) in a major hospital in Addis Ababa, Ethiopia. Sociodemographic and lifestyle characteristics were collected via structured interviews. MDD and suicidal behavior were assessed using the Composite International Diagnostic Interview (CIDI) among all study participants. Multivariable logistic regression models were fitted to estimate odds ratios (OR) and 95% confidence intervals (95% CI).
RESULTS
Prevalence estimates for lifetime and 12-month MDD were 18.0% and 6.7%, respectively. The prevalence of suicidal behavior during the previous year (i.e., suicidal ideation, plan or attempt) was 15.2% with approximately 4% having reported attempts. Overall, women were more likely to report suicidal behavior (17.8%) than men (11.3%). MDD odds were 1.53-fold higher among women as compared with men (aOR=1.53, 95% CI 1.05-2.23). Lifetime MDD was significantly associated with age, sex, marital status, and self-reported physical health. Participants reporting poor mental health had approximately 3-fold increased odds of MDD (OR=2.93; 95%CI: 1.05-2.23); those between 35 and 44 years old (aOR=1.92; 95%CI: 1.06-3.49) and those older than 55 years (aOR=2.54; 95%CI: 1.16-5.57) had higher odds of MDD. Similarly suicidal behavior was significantly associated with sex, marital status, and self-reported physical and mental health.
LIMITATIONS
This cross-sectional study utilized self-reported data from outpatients. Causality cannot be inferred, and results may not be fully generalizable.
CONCLUSIONS
Overall results show that MDD and suicidal behavior are highly prevalent among urban-dwelling Ethiopian adults. Women and middle-age adults constitute a high-risk group and may therefore benefit from targeted interventions.
背景
我们试图评估埃塞俄比亚城市成年居民中重度抑郁症（MDD）和自杀行为的患病率及其相关因素。
方法
这是一项对埃塞俄比亚亚的斯亚贝巴一家大型医院的1097名门诊成年患者（≥18岁）进行的横断面研究。通过结构化访谈收集社会人口学和生活方式特征。使用综合国际诊断访谈（CIDI）对所有研究参与者进行MDD和自杀行为评估。采用多变量逻辑回归模型估计比值比（OR）和95%置信区间（95%CI）。
结果
终生MDD和12个月MDD的患病率估计分别为18.0%和6.7%。前一年自杀行为（即自杀意念、计划或企图）的患病率为15.2%，约4%的人报告有自杀企图。总体而言，女性报告自杀行为的可能性（17.8%）高于男性（11.3%）。女性患MDD的几率比男性高1.53倍（调整后OR=1.53，95%CI 1.05-2.23）。终生MDD与年龄、性别、婚姻状况和自我报告的身体健康显著相关。报告心理健康状况不佳的参与者患MDD的几率增加约3倍（OR=2.93；95%CI：1.05-2.23）；35至44岁的参与者（调整后OR=1.92；95%CI：1.06-3.49）和55岁以上的参与者（调整后OR=2.54；95%CI：1.16-5.57）患MDD的几率更高。同样，自杀行为与性别、婚姻状况以及自我报告的身心健康显著相关。
局限性
这项横断面研究采用了门诊患者的自我报告数据。无法推断因果关系，结果可能无法完全推广。
结论
总体结果表明，MDD和自杀行为在埃塞俄比亚城市成年居民中非常普遍。女性和中年成年人构成高危群体，因此可能受益于有针对性的干预措施。
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