Luitel Nagendra P, Baron Emily C, Kohrt Brandon A, Komproe Ivan H, Jordans Mark J D
Research Department, Transcultural Psychosocial Organization (TPO) Nepal, Kathmandu, Nepal.
Alan J. Flisher Centre for Public Mental Health, University of Cape Town, Cape Town, South Africa.
BMC Health Serv Res. 2018 Mar 27;18(1):215. doi: 10.1186/s12913-018-3034-9.
Although depression and alcohol use disorder (AUD) are expected to be common among patients presenting to primary health care setting, there is limited research on prevalence of depression and AUD among people attending primary health care services in low-income countries. The aim of this study was to assess the prevalence of depression and AUD among adults attending primary care facilities in Nepal and explore factors associated with depression and AUD.
We conducted a population-based cross-sectional health facility survey with 1474 adults attending 10 primary healthcare facilities in Chitwan district, Nepal. The prevalence of depression and AUD was assessed with validated Nepali versions of the Patient Health Questionnaire (PHQ-9) and Alcohol Use Disorder Identification Test (AUDIT).
16.8% of the study sample (females 19.6% and males 11.3%) met the threshold for depression and 7.3% (males 19.8% and females 1.1%) for AUD. The rates of depression was higher among females (RR = 1.48, P = 0.009), whereas rates of AUD was lower among females (RR = 0.49, P = 0.000). Rates of depression and AUD varied based on education, caste/ethnicity, occupations and family income.
In Nepal, one out of five women attending primary care services have depression and one out of five men have AUD. Primary care settings, therefore, are an important setting for detection and treatment initiation for these conditions. Given that "other" occupation is at increased risk for both conditions, it will be important to assure that treatments are feasible and effective for this high risk group.
尽管抑郁症和酒精使用障碍（AUD）在初级卫生保健机构的患者中预计较为常见，但在低收入国家接受初级卫生保健服务的人群中，关于抑郁症和AUD患病率的研究有限。本研究的目的是评估尼泊尔初级保健机构中成年人抑郁症和AUD的患病率，并探讨与抑郁症和AUD相关的因素。
我们在尼泊尔奇旺地区的10所初级卫生保健机构对1474名成年人进行了一项基于人群的横断面卫生机构调查。使用经过验证的尼泊尔语版患者健康问卷（PHQ-9）和酒精使用障碍识别测试（AUDIT）评估抑郁症和AUD的患病率。
16.8%的研究样本（女性为19.6%，男性为11.3%）达到抑郁症阈值，7.3%（男性为19.8%，女性为1.1%）达到AUD阈值。女性的抑郁症患病率较高（RR = 1.48，P = 0.009），而女性的AUD患病率较低（RR = 0.49，P = 0.000）。抑郁症和AUD的患病率因教育程度、种姓/族裔、职业和家庭收入而异。
在尼泊尔，接受初级保健服务的女性中有五分之一患有抑郁症，男性中有五分之一患有AUD。因此，初级保健机构是这些疾病检测和开始治疗的重要场所。鉴于“其他”职业在这两种疾病中的风险增加，确保针对这一高风险群体的治疗可行且有效将非常重要。
