基层医疗中的抑郁问题，2010-2018 年。
Depression in Primary Care, 2010-2018.
机构信息
Clement J. Zablocki Veterans' Administration Medical Center, Milwaukee, Wis.
Kyoto University Graduate School of Medicine, Japan.
出版信息
Am J Med. 2022 Dec;135(12):1505-1508. doi: 10.1016/j.amjmed.2022.06.022. Epub 2022 Jul 22.
BACKGROUND
Depression is common in primary care and significantly reduces quality of life. Our study aimed to examine the prevalence of depression in primary care visits, examine patterns of depression treatment and referral, and determine how often depression screening occurred over an 8-year timespan.
METHODS
From the 2010-2018 National Ambulatory Medical Care Survey, a national probability sample of non-federal, ambulatory encounters, we identified adults being seen in a primary care clinic. We assessed the prevalence of depression screening, diagnosis, and treatment.
RESULTS
During these 8 years, 13.1% of primary care encounters involved a patient with a diagnosis of depression. The prevalence of depression did not change over time. Patients were screened for depression 4.1% of the time, with screening increasing over time. Depression was more likely to be diagnosed when screening occurred (odds ratio 9.9; 95% confidence interval, 6.8-14.5%). Most patients were treated with a selective serotonin reuptake inhibitor.
CONCLUSION
Depression is common in primary care, though screening was infrequent. Practices should consider instituting universal screening.
背景
抑郁症在初级保健中很常见，严重降低了生活质量。我们的研究旨在调查初级保健就诊中抑郁症的患病率，检查抑郁症的治疗和转介模式，并确定在 8 年的时间内抑郁症筛查的发生频率。
方法
我们从 2010 年至 2018 年的全国门诊医疗调查中，选择了一个全国性的非联邦、门诊就诊的概率样本，确定了在初级保健诊所就诊的成年人。我们评估了抑郁症筛查、诊断和治疗的患病率。
结果
在这 8 年中，13.1%的初级保健就诊涉及诊断为抑郁症的患者。抑郁症的患病率没有随时间变化。患者接受抑郁症筛查的时间为 4.1%，筛查随着时间的推移而增加。当进行筛查时，更有可能诊断出抑郁症（比值比 9.9；95%置信区间，6.8-14.5%）。大多数患者接受选择性 5-羟色胺再摄取抑制剂治疗。
结论
抑郁症在初级保健中很常见，尽管筛查频率较低。实践中应考虑实施普遍筛查。
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