Francia Lea, Mediavilla Roberto, Choi Lok Yin, Ayuso-Mateos José Luis, De Giorgi Riccardo
Instituto de Investigación Sanitaria del Hospital Universitario de La Princesa, IIS Princesa, Madrid, Spain.
Department of Psychiatry, Universidad Autónoma de Madrid, C/Arzobispo Morcillo, 4, Madrid, 28029, Spain.
Psychiatr Q. 2024 Dec;95(4):731-746. doi: 10.1007/s11126-024-10093-8. Epub 2024 Sep 30.
The UK National Institute for Health and Care Excellence (NICE) guidance for the treatment of depression is widely followed and has international influence. According to these guidelines, antidepressant medications are recommended for moderate to severe depression. Nonetheless, antidepressants are increasingly prescribed, including for cases of subthreshold and mild depression. This may indicate that a proportion of depressed patients uses pharmacological interventions with unclear evidence-base, though other factors such as physical and mental health comorbidities need to be accounted for. This study aims to investigate the prevalence and trends of antidepressant prescriptions among community-dwelling adults diagnosed with depression according to NICE recommendations. We conducted a systematic review of PsycInfo, PubMed/MEDLINE, and Scopus databases. Observational studies reporting on the prevalence of antidepressant treatments in UK adults diagnosed with depression were sought. Fifteen studies were included. The prevalence of antidepressants for depression treatment ranged from 30.8 to 95% and mainly concerned selective serotonin reuptake inhibitors (SSRIs) among classes of antidepressant drugs. Little information about depression severity as well as comorbid conditions was reported. High prevalence rates of antidepressant drug use highlight the widespread adoption of pharmacological interventions, while also raising concerns about compliance with NICE guidelines. Careful assessment of depressive illness severity and comorbidities is needed to ensure the delivery of adequate care to people with depression. Systematic Review Registration Number (PROSPERO) CRD42023448152.
英国国家卫生与临床优化研究所（NICE）关于抑郁症治疗的指南被广泛遵循且具有国际影响力。根据这些指南，推荐使用抗抑郁药物治疗中度至重度抑郁症。然而，抗抑郁药物的处方越来越多，包括用于阈下和轻度抑郁症病例。这可能表明一部分抑郁症患者使用了证据基础不明确的药物干预措施，不过还需要考虑其他因素，如身心健康合并症。本研究旨在调查根据NICE建议被诊断为抑郁症的社区居住成年人中抗抑郁药物处方的患病率和趋势。我们对PsycInfo、PubMed/MEDLINE和Scopus数据库进行了系统综述。寻找报告英国被诊断为抑郁症的成年人中抗抑郁治疗患病率的观察性研究。纳入了15项研究。用于抑郁症治疗的抗抑郁药物患病率在30.8%至95%之间，且在抗抑郁药物类别中主要涉及选择性5-羟色胺再摄取抑制剂（SSRI）。关于抑郁症严重程度以及合并症的信息报道较少。抗抑郁药物的高使用率凸显了药物干预措施的广泛采用，同时也引发了对是否符合NICE指南的担忧。需要仔细评估抑郁疾病的严重程度和合并症，以确保为抑郁症患者提供充分的护理。系统综述注册号（PROSPERO）CRD42023448152。
