Size and burden of mental disorders in Europe - a critical review and appraisal of 27 studies
Size and burden of mental disorders in Europe - a critical review and appraisal of 27 studies
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DOI：
10.1016/j.euroneuro.2005.04.012
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发表时间：
2005-08-01
影响因子：
5.6
通讯作者：
Jacobi, F
中科院分区：
文献类型：
--
作者：
Wittchen, HU;Jacobi, F
本文介绍了在欧洲国家进行的社区研究中关于各种精神障碍的流行病学数据，以确定欧盟的患病率、残疾和治疗结果的可得性和一致性。采用逐步多方法方法，确定了来自16个欧洲国家的27项符合条件的研究，这些研究的设计和方法各不相同，包括超过15万名受试者。患病率：根据荟萃分析技术以及对选定数据集的再分析，估计在过去12个月里，18-65岁的欧盟成年人口中约有27%（等于8270万；95% Cl: 78.5-87.1）正在或已经受到至少一种精神障碍的影响。考虑到相当程度的共病（约三分之一患有一种以上的疾病），最常见的疾病是焦虑症、抑郁症、躯体形式和物质依赖障碍。当考虑到研究之间的设计、抽样和其他方法差异时，几乎没有证据表明存在相当大的文化或国家差异。残疾和治疗：尽管评估策略非常不同且相当粗糙，但现有数据一致表明：(a)就损失的工作日数量而言，所有精神障碍与相当大的残疾负担存在关联；(b)利用率和治疗率普遍较低。在所有病例中，只有26%的人向专业保健服务机构咨询过，这一发现表明，有相当大程度的需求未得到满足。这篇论文强调了未来在所有疾病和年龄组中协调欧盟研究的相当大的研究需求。由于患病率估计不能简单地等同于确定的治疗需要，这种研究应考虑到严重程度、残疾和合并症，确定满足和未满足服务需要的程度。这些需求在欧盟新成员国以及更普遍的青少年和老年人群体中最为明显。(c) 2005 Elsevier B.V.和ECNP。版权所有。
Epidemiological data on a wide range of mental disorders from community studies conducted in European countries are presented to determine the availability and consistency of prevalence, disability and treatment findings for the EU. Using a stepwise multimethod approach, 27 eligible studies with quite variable designs and methods including over 150,000 subjects from 16 European countries were identified. Prevalence: On the basis of meta-analytic techniques as well as on reanalyses of selected data sets, it is estimated that about 27% (equals 82.7 million; 95% Cl: 78.5-87.1) of the adult EU population, 18-65 of age, is or has been affected by at least one mental disorder in the past 12 months. Taking into account the considerable degree of comorbidity (about one third had more than one disorder), the most frequent disorders are anxiety disorders, depressive, somatoform and substance dependence disorders. When taking into account design, sampling and other methodological differences between studies, little evidence seems to exist for considerable cultural or country variation. Disability and treatment: despite very divergent and fairly crude assessment strategies, the available data consistently demonstrate (a) an association of all mental disorders with a considerable disability burden in terms of number of work days lost (WLD) and (b) generally low utilization and treatment rates. Only 26% of all cases had any consultation with professional health care services, a finding suggesting a considerable degree of unmet need. The paper highlights considerable future research needs for coordinated EU studies across all disorders and age groups. As prevalence estimates could not simply be equated with defined treatment needs, such studies should determine the degree of met and unmet needs for services by taking into account severity, disability and comorbidity. These needs are most pronounced for the new EU member states as well as more generally for adolescent and older populations. (c) 2005 Elsevier B.V. and ECNP. All rights reserved.