在乌干达农村中心，抑郁症状的流行情况及其相关因素，以及干预要点：基于横断面人群的对男女的调查结果。
Prevalence and correlates of depressive symptoms, and points of intervention, in rural central Uganda: results from a cross-sectional population-based survey of women and men.
机构信息
Department of Public Health, The University of Texas at San Antonio, San Antonio, Texas, USA.
Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda.
出版信息
BMJ Open. 2022 May 31;12(5):e054936. doi: 10.1136/bmjopen-2021-054936.
OBJECTIVES
The present study aimed to identify the prevalence and correlates of depressive symptoms and potential intervention points among women and men from a population-based sample in rural central Uganda.
DESIGN
A cross-sectional study.
SETTING
Four districts in rural Uganda.
PARTICIPANTS
Women and men aged 15-59 residing in four districts in rural Uganda accepting home-based HIV testing who completed a baseline survey at the time of testing.
PRIMARY OUTCOME MEASURES
Depressive symptoms measured by the 10-item Center for Epidemiological Studies Depression Scale using a cut-off score of 13 for significant depressive symptoms.
RESULTS
Among a sample of 9609 women and 6059 men, 1415 (14.7%) women and 727 (12.0%) men met criteria for significant depressive symptoms. Having ever received mental health services was associated with lower odds of significant depressive symptoms (women: adjusted OR (adjOR)=0.32, 95% CI=0.22 to 0.47; men: adjOR=0.36, 95% CI=0.18 to 0.62). Having received outpatient (women: adjOR=3.64, 95% CI=3.14 to 4.22; men: adjOR=3.37, 95% CI=2.78 to 4.07) or inpatient (women: adjOR=5.44, 95% CI=4.24 to 6.97; men: adjOR=3.42, 95% CI=2.21 to 5.28) care in the prior 6 months was associated with greater odds of significant depressive symptoms. For women only, known HIV positive status (adjOR=1.37, 95% CI=1.05 to 1.77), and for men only, alcohol misuse (adjOR=1.38, 95% CI=1.12 to 1.70), were associated with increased odds of significant depressive symptoms.
CONCLUSION
Our findings suggest that depression screening within outpatient and inpatient settings may help to identify people in need of mental health services. Routine screening in outpatient or inpatient clinics along with the implementation of evidence-based interventions could ultimately help close the mental health gap for depression in this and similar settings.
目的
本研究旨在确定乌干达农村地区一个基于人群的样本中女性和男性的抑郁症状的流行率和相关因素，以及可能的干预点。
设计
横断面研究。
地点
乌干达四个地区。
参与者
接受家庭为基础的艾滋病毒检测的年龄在 15-59 岁的女性和男性，在检测时完成基线调查。
主要结局测量
使用 10 项中心流行病学研究抑郁量表，以 13 分为显著抑郁症状的截断值来衡量抑郁症状。
结果
在 9609 名女性和 6059 名男性样本中，1415 名（14.7%）女性和 727 名（12.0%）男性符合显著抑郁症状的标准。曾经接受过心理健康服务与显著抑郁症状的可能性较低相关（女性：调整后的比值比（adjOR）=0.32，95%可信区间（CI）=0.22 至 0.47；男性：adjOR=0.36，95%CI=0.18 至 0.62）。在过去 6 个月内接受过门诊（女性：adjOR=3.64，95%CI=3.14 至 4.22；男性：adjOR=3.37，95%CI=2.78 至 4.07）或住院（女性：adjOR=5.44，95%CI=4.24 至 6.97；男性：adjOR=3.42，95%CI=2.21 至 5.28）治疗与显著抑郁症状的可能性增加相关。仅对女性而言，已知的艾滋病毒阳性状态（adjOR=1.37，95%CI=1.05 至 1.77），仅对男性而言，酒精滥用（adjOR=1.38，95%CI=1.12 至 1.70）与显著抑郁症状的可能性增加相关。
结论
我们的研究结果表明，在门诊和住院环境中进行抑郁筛查可能有助于发现需要心理健康服务的人。在门诊或住院诊所进行常规筛查，并实施基于证据的干预措施，最终可能有助于缩小该人群和类似人群中抑郁的心理健康差距。
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