Longitudinal investigation of depression outcomes in primary care in six countries: the LIDO Study. Functional status, health service use and treatment of people with depressive symptoms
Longitudinal investigation of depression outcomes in primary care in six countries: the LIDO Study. Functional status, health service use and treatment of people with depressive symptoms
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DOI：
10.1017/s003329170200586x
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发表时间：
2002-07-01
影响因子：
6.9
通讯作者：
Buesching, DP
中科院分区：
文献类型：
--
作者：
Herrman, H;Patrick, DL;Buesching, DP
背景在不同国家的六个地点的初级保健患者中进行了抑郁症状的筛选调查。LIDO研究旨在评估生活质量和抑郁症的经济相关性及其在文化多样性的初级卫生保健环境中的治疗。本文介绍：（1）抑郁症状与功能状态、总体健康相关生活质量（QoL）以及不同文化背景下一般健康服务的使用之间的关联;（2）在有抑郁症状的受试者中，与近期抑郁治疗相关的因素。从Be'er Sheva（以色列）、波尔图阿莱格雷（巴西）、墨尔本（澳大利亚）、巴塞罗那（西班牙）、圣彼得堡（俄罗斯联邦）和西雅图（美国）的参与初级保健机构招募18 - 75岁的受试者。使用CES-D测量抑郁症状。同时还进行了SF-12、生活质量总体问题、选定的人口统计学和社会学指标、近期抑郁症治疗情况、医疗服务使用情况和工作日损失情况。共筛选了18489例患者，其中37%（范围24-55%）的CES-D评分≥ 16，28%（范围17-42%）的评分≥ 20。总体而言，13%的患者报告目前正在接受抑郁症治疗（范围为4 - 23%）。抑郁症状评分较高的患者的健康状况、功能状态、生活质量较差，并且在所有研究中心都更多地使用卫生服务。在CES-D评分大于或等于16的受试者中，报告抑郁症治疗的受试者比报告未治疗的受试者更有可能对自己的健康不满意（圣彼得堡除外），并且抑郁症状评分更高。在初级保健患者中，较高的抑郁症状评分与较差的健康状况、功能状态和生活质量以及增加的医疗保健使用相关，但与人口统计学变量无关。抑郁症治疗的可能性与健康状况以及抑郁症的严重程度有关。
Background. Screening surveys of depressive symptoms were conducted among primary care patients at six sites in different countries. The LIDO Study was designed to assess quality of life and economic correlates of depression and its treatment in culturally diverse primary health care settings. This paper describes: (1) the association between depressive symptoms and functional status, global health-related quality of life (QoL), and use of general health services across different cultural settings; and (2) among subjects with depressive symptoms, the factors associated with recent treatment for depression.Methods. Subjects aged 18 to 75 were recruited from participating primary care facilities in Be'er Sheva (Israel), Porto Alegre (Brazil), Melbourne (Australia), Barcelona (Spain), St Petersburg (Russian Federation) and Seattle (USA). Depressive symptoms were measured using the CES-D. Also administered were the SF-12, global questions on QoL, selected demographic and social measures, and questions on recent treatment for depression, use of health care services, and lost workdays.Results. A total of 18 489 patients were screened, of whom 37% overall (range 24-55%) scored greater than or equal to16 on the CES-D and 28% (range 17-42%) scored greater than or equal to 20. Overall, 13% reported current treatment for depression (range 4 to 23%). Patients with higher depressive symptom scores had worse health, functional status, QoL, and greater use of health services across all sites. Among those with a CES-D score greater than or equal to 16, subjects reporting treatment for depression were more likely than those reporting no treatment to be dissatisfied with their health (except in St Petersburg), and to have higher depressive symptom scores.Conclusions. Higher depressive symptom scores in primary care patients were consistently associated with poorer health, functional status and QoL, and increased health care use, but not with demographic variables. The likelihood of treatment for depression was associated with perceptions of health, as well as severity of the depression.