Freemasons Centre for Male Health and Wellbeing, The University of Adelaide, Adelaide, South Australia, Australia
Health and Biosecurity, Commonwealth Scientific and Industrial Research Organisation (CSIRO), Adelaide, South Australia, Australia.
BMJ Open. 2021 Mar 17;11(3):e044893. doi: 10.1136/bmjopen-2020-044893.
To examine the relationship between depression burden, health service utilisation and depression diagnosis in community-based men.
Prospective cohort study.
Community-based.
Men aged 35-80 years at recruitment (2002-2005), randomly selected from the northern and western suburbs of Adelaide, Australia, without depression at baseline, who attended follow-up visits (2007-2010) (n=1464).
Depression symptoms were categorised into high burden (total score of ≥13 for the Beck Depression Inventory (BDI) or ≥10 for the Centre for Epidemiologic Studies Depression Scale (CES-D) or low burden (<13 for the BDI or <10 for the CES-D). Diagnosed depression was determined by patient-reported physician diagnosis. Frequent general practitioner (GP) visits were those occurring 5+ times over the preceding year. Use of national medical and prescription services (Medicare Benefit Schedule and Pharmaceutical Benefit Scheme; MBS and PBS) was assessed through data linkage.
Frequent attendance and depression diagnosis was more common in men with a high than low burden of depression symptoms (45.9% vs 29.3%-18.7% vs 1.9%, p<0.001). Depression diagnoses were also more common in frequent GP attenders compared with low-average attenders (5.1% vs 2.2%, p<0.001). Among men with high burden of symptoms, there was no age-adjusted or multi-adjusted difference for likelihood of depression diagnosis between non-regular and frequent GP attenders. Annualised MBS and PBS expenditure was highest for men with undiagnosed depression.
Men with a high burden of depression symptoms have commensurate use of health services when compared with those with a low burden, but only half report a physician diagnosis of depression. Undiagnosed depression led to a higher usage of medical and prescription services.
研究社区男性人群中抑郁负担、卫生服务利用与抑郁诊断之间的关系。
前瞻性队列研究。
社区。
招募时年龄为 35-80 岁的男性（2002-2005 年），来自澳大利亚阿德莱德市北部和西部郊区，基线时无抑郁，参加了随访（2007-2010 年）（n=1464）。
抑郁症状分为高负担（贝克抑郁量表（BDI）总分≥13 或流行病学研究抑郁量表（CES-D）总分≥10）和低负担（BDI 总分<13 或 CES-D 总分<10）。诊断性抑郁通过患者报告的医生诊断确定。频繁看全科医生（GP）是指过去一年就诊 5 次以上。通过数据链接评估国家医疗和处方服务（医疗保险福利计划和药品福利计划；MBS 和 PBS）的使用情况。
高负担抑郁症状男性的频繁就诊和诊断率高于低负担者（45.9%比 29.3%-18.7%比 1.9%，p<0.001）。与低就诊频率者相比，频繁就诊者的抑郁诊断也更为常见（5.1%比 2.2%，p<0.001）。在高症状负担的男性中，非定期和频繁看 GP 的患者，其抑郁诊断的可能性在年龄调整或多因素调整后没有差异。未确诊的抑郁症患者的年度 MBS 和 PBS 支出最高。
与低负担者相比，高负担抑郁症状的男性有相当的卫生服务利用，但只有一半报告有医生诊断的抑郁。未确诊的抑郁症导致更高的医疗和处方服务使用。
