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全球抑郁症患病率和发病率的趋势:系统回顾和荟萃分析。

Global trends in the prevalence and incidence of depression:a systematic review and meta-analysis.

机构信息

Department of Health Service and Population Research, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK.

Department of Health Service and Population Research, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK.

出版信息

J Affect Disord. 2021 Feb 15;281:235-243. doi: 10.1016/j.jad.2020.12.035. Epub 2020 Dec 9.

Abstract

BACKGROUND

There is mixed evidence regarding the change in the prevalence of depression in the general population over time. This study aimed to synthesise the evidence on studies that use equivalent approaches in equivalent populations across different time points.

METHODS

A systematic review was conducted to identify studies focused on the change over time in depression incidence and prevalence in the general population. A random-effects meta-analysis was performed to obtain a pooled effect for the change in the prevalence estimates between the first and last time points considered. Subgroup and meta-regression analyses were used to ascertain differences in the effect sizes by gender, age group, prevalence type, elapsed time between cross-sections, and depression operationalisation.

RESULTS

19 studies provided information on the change in depression prevalence over time, whereas none provided such information regarding incidence. The pooled odds ratio (OR) and confidence interval (CI) were estimated by using 17 studies: OR=1.35 (95% CI: 1.14, 1.61). Similar pooled effects were obtained for females and males, separately. The high heterogeneity across studies was not explained by any of the design variables considered. No evidence for publication bias was found.

LIMITATIONS

The review included published articles up to August 2018, and the information of studies with more than two time points was summarised in a single estimate of change.

CONCLUSIONS

There is a predominant increasing trend in the likelihood of experiencing depression over time that seems not to be explainable by study design differences or publication bias alone.

摘要

背景

关于一般人群中抑郁患病率随时间变化的证据存在差异。本研究旨在综合使用等效方法在不同时间点对等效人群进行研究的证据。

方法

系统检索了关于一般人群中抑郁发生率和患病率随时间变化的研究。采用随机效应荟萃分析获得考虑的第一和最后时间点之间患病率估计值变化的汇总效应。进行亚组和荟萃回归分析,以确定性别、年龄组、患病率类型、横断面之间的时间间隔以及抑郁操作化等因素对效应大小的差异。

结果

19 项研究提供了关于随时间变化的抑郁患病率变化的信息,而没有提供关于发病率的信息。使用 17 项研究估计了汇总优势比 (OR) 和置信区间 (CI):OR=1.35(95%CI:1.14,1.61)。对女性和男性分别进行的汇总效果相似。研究之间的高度异质性不能用任何考虑到的设计变量来解释。未发现发表偏倚的证据。

局限性

本综述纳入了截至 2018 年 8 月的已发表文章,且超过两个时间点的研究信息汇总为单一的变化估计值。

结论

随着时间的推移,经历抑郁的可能性呈明显上升趋势,这似乎不能仅用研究设计差异或发表偏倚来解释。

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