Maske Ulrike E, Hapke Ulfert, Riedel-Heller Steffi G, Busch Markus A, Kessler Ronald C
Department of Epidemiology and Health Monitoring, Division 26 Mental Health, Robert Koch Institute, Berlin, Germany.
Institute of Social Medicine, Occupational Health and Public Health (ISAP), Faculty of Medicine, University of Leipzig, Leipzig, Germany.
BMC Psychiatry. 2017 Jan 23;17(1):39. doi: 10.1186/s12888-017-1203-8.
Respondents' report of a previously diagnosed depression by a health professional is frequently used to estimate depression prevalence. This study contributes to a better understanding of survey results based on this measure by comparing it with a comprehensive standardized diagnostic interview.
Data came from the cross-sectional nationwide German Health Interview and Examination Survey for Adults (DEGS1) and its mental health module (DEGS1-MH, n = 4483). In DEGS1, participants were asked whether they have been diagnosed with depression by a physician or psychotherapist (last 12-month). DSM-IV-based 12-month major depressive disorder (MDD) and other mental disorders were assessed with the German version of the Composite International Diagnostic Interview (CIDI). Time lag between both assessments was 6 weeks (median).
73.4% of participants reporting clinician-diagnosed depression met criteria for any mental disorder in the CIDI (any affective disorder: 51.8%, any anxiety disorder: 54.7%). The proportion of participants reporting a clinician-diagnosed depression who met MDD criteria was highest among those aged 18-29 years (62.6%) and decreased with age (65-79 years: 29.8%). Among participants with MDD, the proportion with clinician-diagnosed depression was 33.0%, highest among those aged 45-64 years (49.3%) and lowest among those aged 18-29 years (22.7%) and 30-44 years (20.3%). MDD severity was positively associated with clinician-diagnosed depression.
Respondents' report of a clinician-diagnosed depression and major depression assessed with the CIDI substantially differ. Concordance of both measures varies with age and severity of depressive symptoms. Health surveys should assess a range of depression indicators in order to cover a wide spectrum.
通过健康专业人员报告先前诊断出的抑郁症情况，常常被用于估计抑郁症患病率。本研究通过将其与全面的标准化诊断访谈进行比较，有助于更好地理解基于该测量方法得出的调查结果。
数据来自德国全国性成人健康访谈与检查调查（DEGS1）及其心理健康模块（DEGS1-MH，n = 4483）。在DEGS1中，参与者被问及他们是否曾被医生或心理治疗师诊断患有抑郁症（过去12个月内）。基于《精神疾病诊断与统计手册第四版》（DSM-IV）的12个月重度抑郁症（MDD）及其他精神障碍，采用德语版综合国际诊断访谈（CIDI）进行评估。两次评估之间的时间间隔为6周（中位数）。
报告经临床医生诊断患有抑郁症的参与者中，73.4%符合CIDI中任何精神障碍的标准（任何情感障碍：51.8%，任何焦虑障碍：54.7%）。报告经临床医生诊断患有抑郁症且符合MDD标准的参与者比例，在18 - 29岁年龄组中最高（62.6%），并随年龄增长而下降（65 - 7九岁：29.8%）。在患有MDD的参与者中，经临床医生诊断患有抑郁症的比例为33.0%，在45 - 64岁年龄组中最高（49.3%）,在18 - 29岁年龄组（22.7%）和30 - 44岁年龄组（20.3%）中最低。MDD严重程度与经临床医生诊断的抑郁症呈正相关。
参与者报告的经临床医生诊断的抑郁症与用CIDI评估的重度抑郁症有很大差异。两种测量方法的一致性随年龄和抑郁症状严重程度而变化。健康调查应评估一系列抑郁症指标，以便涵盖广泛范围。
