The epidemiology of major depressive episodes:: results from the International Consortium of Psychiatric Epidemiology (ICPE) Surveys
The epidemiology of major depressive episodes:: results from the International Consortium of Psychiatric Epidemiology (ICPE) Surveys
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DOI：
10.1002/mpr.138
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发表时间：
2003-01-01
影响因子：
3.1
通讯作者：
Wittchen, HU
中科院分区：
文献类型：
--
作者：
Andrade, L;Caraveo-Anduaga, JJ;Wittchen, HU
缺乏一种通用的诊断访谈方式，阻碍了对重性抑郁发作（MDE）流行病学证据的跨国综合研究。在北美洲（加拿大和美国）、拉丁美洲（巴西、智利和墨西哥）、欧洲（捷克共和国、德国、荷兰和土耳其）以及亚洲（日本）的10个国家开展了社区流行病学调查，使用的是世界卫生组织复合性国际诊断访谈，且是面对面进行的。总样本量超过37000人。无层级的《精神障碍诊断与统计手册》第三版修订版/第四版中重性抑郁发作的终生患病率估计值差异很大，从日本的3%到美国的16.9%不等，大多数在8% - 12%的范围内。12个月/终生患病率之比在40% - 55%的范围内，30天/12个月患病率之比在45% - 65%的范围内，大多数国家的发病中位年龄在20 - 25岁之间。一致的社会人口学相关因素包括女性和未婚。近期队列中的受访者报告的终生患病率较高，但持续性低于早期队列。在所有国家都发现重性抑郁发作与焦虑障碍有很强的共病性，且在时间上继发于焦虑障碍，其中原发性惊恐障碍和广泛性焦虑障碍是继发性重性抑郁发作首次发病的最强预测因素。重性抑郁发作是一种常见疾病，通常呈慢性间歇性病程。需要进行有效性试验，以评估早期发现和治疗对重性抑郁发作病程的影响，以及评估对原发性焦虑障碍的及时治疗是否会减少继发性重性抑郁发作的后续发病、持续性和严重程度。
Absence of a common diagnostic interview has hampered cross-national syntheses of epidemiological evidence on major depressive episodes (MDE). Community epidemiological surveys using the World Health Organization Composite International Diagnostic Interview administered face-to-face were carried out in 10 countries in North America (Canada and the US), Latin America (Brazil, Chile, and Mexico), Europe (Czech Republic, Germany, the Netherlands, and Turkey), and Asia (Japan). The total sample size was more than 37,000.Lifetime prevalence estimates of hierarchy-free DSM-III-R/DSM-IV MDE varied widely, from 3% in Japan to 16.9% in the US, with the majority in the range of 8% to 12%. The 12-month/life time prevalence ratio was in the range 40% to 55%, the 30-day/12-month prevalence ratio in the range 45% to 65%, and median age of onset in the range 20 to 25 in most countries. Consistent socio-demographic correlates included being female and unmarried. Respondents in recent cohorts reported higher lifetime prevalence, but lower persistence than those in earlier cohorts. Major depressive episodes were found to be strongly co-morbid with, and temporally secondary to, anxiety disorders in all countries, with primary panic and generalized anxiety disorders the most powerful predictors of the first onset of secondary MDE.Major depressive episodes are a commonly occurring disorder that usually has a chronic-intermittent course. Effectiveness trials are needed to evaluate the impact of early detection and treatment on the course of MDE as well as to evaluate whether timely treatment of Primary anxiety disorders would reduce the subsequent onset, persistence, and severity of secondary MDE.