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在俄罗斯的两个城市中,一般人群中症状的流行率、曾经接受过抑郁症和焦虑症的诊断和治疗以及与卫生服务使用的关系。

Prevalence of symptoms, ever having received a diagnosis and treatment of depression and anxiety, and associations with health service use amongst the general population in two Russian cities.

机构信息

Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway.

Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.

出版信息

BMC Psychiatry. 2020 Nov 12;20(1):537. doi: 10.1186/s12888-020-02938-w.

Abstract

BACKGROUND

Little is known about the burden of common mental disorders in Russia despite high levels of suicide and alcohol-related mortality. Here we investigated levels of symptoms, self-reports of ever having received a diagnosis and treatment of anxiety and depression in two Russian cities.

METHODS

The study population was men and women aged 35-69 years old participating in cross-sectional population-based studies in the cities of Arkhangelsk and Novosibirsk (2015-18). Participants completed an interview which included the PHQ-9 and GAD-7 scales, questions on whether participants had ever received a diagnosis of depression or anxiety, and health service use in the past year. Participants also reported current medication use and medications were coded in line with the WHO anatomical therapeutic classification (ATC). Depression was defined as PHQ-9 ≥ 10 and Anxiety as GAD-7 ≥ 10.

RESULTS

Age-standardised prevalence of PHQ-9 ≥ 10 was 10.7% in women and 5.4% in men (GAD-7 ≥ 10 6.2% in women; 3.0% in men). Among those with PHQ-9 ≥ 10 17% reported ever having been diagnosed with depression (equivalent finding for anxiety 29%). Only 1.5% of those with PHQ-9 ≥ 10 reported using anti-depressants and 0.6% of those with GAD-7 ≥ 10 reported using anxiolytics. No men with PHQ-9 ≥ 10 and/or GAD-7 ≥ 10 reported use of anti-depressants or anxiolytics. Use of health services increased with increasing severity of both depression and anxiety.

CONCLUSION

There was a large gap between symptoms and reporting of past diagnosis and treatment of common mental disorders in two Russian cities. Interventions aimed at improving mental health literacy and reducing stigma could be of benefit in closing this substantial treatment gap.

摘要

背景

尽管自杀和与酒精相关的死亡率很高,但俄罗斯常见精神障碍的负担知之甚少。在这里,我们调查了两个俄罗斯城市中焦虑和抑郁症状、自我报告曾被诊断和治疗的水平。

方法

研究人群为年龄在 35-69 岁的男性和女性,参加了在阿尔汉格尔斯克和新西伯利亚市进行的横断面基于人群的研究(2015-18 年)。参与者完成了一次访谈,其中包括 PHQ-9 和 GAD-7 量表,询问参与者是否曾被诊断为抑郁症或焦虑症,以及过去一年的卫生服务使用情况。参与者还报告了当前的用药情况,药物按照世界卫生组织解剖治疗分类(ATC)进行编码。抑郁症定义为 PHQ-9≥10,焦虑症定义为 GAD-7≥10。

结果

经过年龄标准化后,女性 PHQ-9≥10 的患病率为 10.7%,男性为 5.4%(GAD-7≥10 女性为 6.2%;男性为 3.0%)。在 PHQ-9≥10 的人群中,17%的人报告曾被诊断为抑郁症(焦虑症的相应比例为 29%)。只有 1.5%的 PHQ-9≥10 的人报告使用抗抑郁药,0.6%的 GAD-7≥10 的人报告使用抗焦虑药。没有 PHQ-9≥10 和/或 GAD-7≥10 的男性报告使用抗抑郁药或抗焦虑药。随着抑郁和焦虑严重程度的增加,对卫生服务的使用也随之增加。

结论

在两个俄罗斯城市中,症状与常见精神障碍过去诊断和治疗的报告之间存在很大差距。旨在提高心理健康知识水平和减少污名化的干预措施可能有助于缩小这一巨大的治疗差距。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/31ea/7663865/ef837b5dd8b3/12888_2020_2938_Fig1_HTML.jpg

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