Barrett J E, Barrett J A, Oxman T E, Gerber P D
Department of Community and Family Medicine, Dartmouth Medical School, Hanover, NH 03756.
Arch Gen Psychiatry. 1988 Dec;45(12):1100-6. doi: 10.1001/archpsyc.1988.01800360048007.
Using a two-stage case identification process, patients from a rural primary care practice were assessed for psychiatric disorders (Research Diagnostic Criteria [RDC] categories) over a 15-month period. The prevalence of all psychiatric disorders was 26.5%; 10.0% were specific RDC depressive disorders, and 5.3% were disorders without depression, usually anxiety related. Another 11.2% of patients were thought to have a disorder with significant depressive symptomatology that could not be classified into a specific depressive disorder category, a finding that suggests restricted usefulness of specialty-based categories for the range of clinical presentations in primary care. The relationship of demographic variables to specific disorders was examined; there were age, sex, and marital status differences in the rates for certain disorders, although these findings need replication using large patient samples. The prevalence findings emphasize the need for research on outcome and treatment response for depression presentations in primary care.
采用两阶段病例识别流程，在15个月的时间里，对一家农村基层医疗诊所的患者进行了精神障碍（研究诊断标准[RDC]类别）评估。所有精神障碍的患病率为26.5%；10.0%为特定的RDC抑郁障碍，5.3%为无抑郁的障碍，通常与焦虑相关。另有11.2%的患者被认为患有具有显著抑郁症状但无法归类为特定抑郁障碍类别的疾病，这一发现表明基于专科的类别对于基层医疗中临床表现范围的实用性有限。研究了人口统计学变量与特定疾病的关系；某些疾病的发病率在年龄、性别和婚姻状况方面存在差异，尽管这些发现需要使用大量患者样本进行重复验证。患病率研究结果强调了对基层医疗中抑郁表现的结局和治疗反应进行研究的必要性。
