加泰罗尼亚初级保健中精神健康诊断的趋势及相关因素（2010 - 2019年）
Trends and associated factors of mental health diagnoses in Catalan Primary Care (2010-2019).
作者信息
Mas Ariadna, Clougher Derek, Anmella Gerard, Valenzuela-Pascual Clàudia, De Prisco Michele, Oliva Vincenzo, Fico Giovanna, Grande Iria, Morilla Ivette, Segú Xavier, Primé-Tous Mireia, Ruíz Victoria, Also María Antonieta, Murgui Sandra, Sant Elisenda, Sans-Corrales Mireia, Fullana Miquel Àngel, Sisó-Almirall Antoni, Radua Joaquim, Blanch Jordi, Cavero Myriam, Vieta Eduard, Hidalgo-Mazzei Diego
机构信息
Department of Psychiatry and Psychology, Hospital Clínic de Barcelona, Catalonia, Barcelona, Spain.
Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Catalonia, Barcelona, Spain.
出版信息
Eur Psychiatry. 2024 Dec 10;67(1):e81. doi: 10.1192/j.eurpsy.2024.1793.
BACKGROUND
The prevalence of mental health disorders has significantly increased in recent years, posing substantial challenges to healthcare systems worldwide, particularly primary care (PC) settings. This study examines trends in mental health diagnoses in PC settings in Catalonia from 2010 to 2019 and identifies associated sociodemographic, clinical characteristics, psychopharmacological treatments, and resource utilization patterns.
METHODS
Data from 947,698 individuals without prior severe mental illness, derived from the Data Analytics Program for Health Research and Innovation (PADRIS), were analyzed for this study. Sociodemographic data, diagnoses, and resource utilization were extracted from electronic health records. Descriptive statistics, chi-square tests, Mann-Whitney tests, and a multivariate binary logistic regression were employed to analyze the data.
RESULTS
Over the study period, 172,112 individuals (18.2%) received at least one mental health diagnosis in PC, with unspecified anxiety disorder (40.5%), insomnia (15.7%) and unspecified depressive disorder (10.2%) being the most prevalent. The prevalence of these diagnoses increased steadily until 2015 and stabilized thereafter. Significant associations were found between mental health diagnoses, female sex, lower socioeconomic status, higher BMI, and smoking status in a multivariate binary logistic regression.
CONCLUSIONS
This study highlights a growing burden of stress-related mental health diagnoses in PC in Catalonia, driven by demographic and socioeconomic factors. These findings may be indicative of broader trends across Europe and globally. Addressing this rising prevalence requires innovative approaches and collaborative strategies that extend beyond traditional healthcare resources. Engaging stakeholders is essential for implementing effective, sustainable solutions that promote mental health in Catalonia and potentially inform similar initiatives worldwide.
背景
近年来，心理健康障碍的患病率显著上升，给全球医疗系统，尤其是基层医疗（PC）机构带来了巨大挑战。本研究考察了2010年至2019年加泰罗尼亚基层医疗机构心理健康诊断的趋势，并确定了相关的社会人口学、临床特征、心理药物治疗及资源利用模式。
方法
本研究分析了来自健康研究与创新数据分析项目（PADRIS）的947,698名无既往严重精神疾病个体的数据。从电子健康记录中提取社会人口学数据、诊断信息及资源利用情况。采用描述性统计、卡方检验、曼-惠特尼检验及多元二元逻辑回归分析数据。
结果
在研究期间，172,112名个体（18.2%）在基层医疗中至少接受过一次心理健康诊断，最常见的是未特定的焦虑症（40.5%）、失眠（15.7%）和未特定的抑郁症（10.2%）。这些诊断的患病率在2015年前稳步上升，此后趋于稳定。多元二元逻辑回归分析发现心理健康诊断与女性、社会经济地位较低、体重指数较高及吸烟状况之间存在显著关联。
结论
本研究强调了加泰罗尼亚基层医疗中与压力相关的心理健康诊断负担日益加重，这是由人口和社会经济因素驱动的。这些发现可能表明欧洲乃至全球更广泛的趋势。应对这一不断上升的患病率需要创新方法和合作策略，超越传统医疗资源。让利益相关者参与对于实施促进加泰罗尼亚心理健康并可能为全球类似举措提供参考的有效、可持续解决方案至关重要。
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