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印度塞霍雷地区成年人抑郁症的预测因素、求助行为及治疗覆盖率

Predictors, help-seeking behaviour and treatment coverage for depression in adults in Sehore district, India.

作者信息

Shidhaye Rahul, Lyngdoh Tanica, Murhar Vaibhav, Samudre Sandesh, Krafft Thomas

机构信息

, MD, Associate Professor, Centre for Chronic Conditions and Injuries, Public Health Foundation of India, New Delhi, India; CAPHRI (Care and Public Health Research Institute), Maastricht University, Maastricht, The Netherlands, and Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

, MD, MSc, PhD, Associate Professor, Indian Institute of Public Health Delhi, Public Health Foundation of India, New Delhi, India.

出版信息

BJPsych Open. 2017 Sep 11;3(5):212-222. doi: 10.1192/bjpo.bp.116.004648. eCollection 2017 Sep.

Abstract

BACKGROUND

National Mental Health Survey found that in India, the point prevalence of major depressive disorder (MDD) was 2.7% and the treatment gap was 85.2%, whereas in Madhya Pradesh the point prevalence of MDD was 1.4% and the treatment gap was 80%.

AIMS

To describe the baseline prevalence of depression among adults, association of various demographic and socioeconomic variables with depression and estimation of contact coverage for the same.

METHOD

Population-based cross-sectional survey of 3220 adults in Sehore district of Madhya Pradesh, India. The outcome of interest was a probable diagnosis of depression that was measured using the Patient Health Questionnaire (PHQ-9) and the proportion of individuals with depression (PHQ-9>9) who sought care for the same. The data were analysed using simple and multiple log-linear regression.

RESULTS

Low educational attainment, unemployment and indebtedness were associated with both moderate/severe depression (PHQ-9 score >9) and severe depression only (PHQ-9 score >14), whereas age, caste and marital status were associated with only moderate or severe depression. Religion, type of house, land ownership and amount of loan taken were not associated with either moderate/severe or only severe depression. The contact coverage for moderate/severe depression was 13.08% (95% CI 10.2-16.63).

CONCLUSIONS

There is an urgent need to bridge the treatment gap by targeting individuals with social vulnerabilities and integrating evidence-based interventions in primary care.

DECLARATION OF INTEREST

None.

COPYRIGHT AND USAGE

© The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license.

摘要

背景

全国心理健康调查发现,在印度,重度抑郁症(MDD)的时点患病率为2.7%,治疗缺口为85.2%,而在中央邦,MDD的时点患病率为1.4%,治疗缺口为80%。

目的

描述成年人中抑郁症的基线患病率、各种人口统计学和社会经济变量与抑郁症的关联,并估计其就诊覆盖率。

方法

对印度中央邦塞霍雷区的3220名成年人进行基于人群的横断面调查。感兴趣的结果是使用患者健康问卷(PHQ-9)测量的可能的抑郁症诊断,以及为抑郁症寻求治疗的个体比例(PHQ-9>9)。数据采用简单和多元对数线性回归进行分析。

结果

低教育程度、失业和负债与中度/重度抑郁症(PHQ-9评分>9)和仅重度抑郁症(PHQ-9评分>14)均相关,而年龄、种姓和婚姻状况仅与中度或重度抑郁症相关。宗教、房屋类型、土地所有权和贷款金额与中度/重度抑郁症或仅重度抑郁症均无关。中度/重度抑郁症的就诊覆盖率为13.08%(95%可信区间10.2-16.63)。

结论

迫切需要通过针对具有社会脆弱性的个体并将循证干预措施纳入初级保健来弥合治疗缺口。

利益声明

无。

版权和使用

©皇家精神科医学院2017年。本文是一篇开放获取文章,根据知识共享非商业性、无衍生作品(CC BY-NC-ND)许可条款分发。

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