Major depression in individuals with chronic medical disorders: prevalence, correlates and association with health resource utilization, lost productivity and functional disability
Major depression in individuals with chronic medical disorders: prevalence, correlates and association with health resource utilization, lost productivity and functional disability
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DOI：
10.1016/j.genhosppsych.2007.06.002
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发表时间：
2007-09-01
影响因子：
7
通讯作者：
Egede, Leonard E.
中科院分区：
文献类型：
--
作者：
Egede, Leonard E.
目的：本研究的目的是确定重度抑郁症的患病率和几率，以及重度抑郁症对患有常见慢性疾病的个体的利用率、生产力损失和功能障碍的增量影响。方法：对来自 1999 年全国健康访谈调查的 30,801 名成年人的数据进行了分析。计算了患有高血压（HTN）、糖尿病（DM）、冠状动脉疾病（CAD）、充血性心力衰竭（CHF）、中风或脑血管意外（CVA）、慢性阻塞性肺病（COPD）和终末期肾病（ESRD）的成年人的12个月患病率和年龄/性别调整后的重性抑郁几率。通过控制协变量确定慢性病状态（有或没有重度抑郁症）与利用率、生产力损失和功能障碍之间的关联。结果：慢性病导致重度抑郁症的 12 个月患病率和年龄/性别调整后的几率如下：CHF，7.9% [优势比 (OR)=1.96]； HTN，8.0%（OR=2.00）； DM，9.3%（OR=1.96）；加元，9.3%（OR=2.30）； CVA，11.4%（OR=3.15）；慢性阻塞性肺病，15.4%（OR=3.21）； ESRD，17.0%（OR=3.56）；任何慢性病，8.8% (OR=2.61)。与没有慢性病的成年人相比，患有慢性病加重度抑郁症的成年人≥1次门诊就诊的几率更大[OR=1.50；OR=1.50； 95％置信区间（95％CI）=1.28，1.77]； >= 1 次急诊室就诊（OR=1.94；95% CI=1.55, 2.45）；因病卧床 >= 1 天（OR=1.60；95% CI=1.28, 2.00）；和功能障碍（OR=2.48；95% CI=1.96, 3.15）。 结论：慢性病患者的 12 个月重度抑郁症患病率和几率较高，并且重度抑郁症与利用率显着增加、生产力损失和功能障碍相关。 (C) 2007 Elsevier Inc. 保留所有权利。
Objective: The objective of this study was to determine the prevalence and odds of major depression and the incremental effect of major depression on utilization, lost productivity and functional disability in individuals with common chronic medical disorders.Method: Data on 30,801 adults from the 1999 National Health Interview Survey were analyzed. The 12-month prevalence and age/sex-adjusted odds of major depression were calculated for adults with hypertension (HTN), diabetes mellitus (DM), coronary artery disease (CAD), congestive heart failure (CHF), stroke or cerebrovascular accident (CVA), chronic obstructive pulmonary disease (COPD) and end-stage renal disease (ESRD). The association between chronic condition status (with and without major depression) and utilization, lost productivity and functional disability was determined by controlling for covariates.Results: The 12-month prevalence and age/sex-adjusted odds of major depression by chronic conditions were as follows: CHF, 7.9% [odds ratio (OR)=1.96]; HTN, 8.0% (OR=2.00); DM, 9.3% (OR=1.96); CAD, 9.3% (OR=2.30); CVA, 11.4% (OR=3.15); COPD, 15.4% (OR=3.21); ESRD, 17.0% (OR=3.56); any chronic condition, 8.8% (OR=2.61). Compared to adults without chronic conditions, those with chronic conditions plus major depression had greater odds of >= 1 ambulatory visit [OR=1.50; 95% confidence interval (95% CI)=1.28, 1.77]; >= 1 emergency room visit (OR=1.94; 95% CI=1.55, 2.45); and >= 1 day in bed due to illness (OR=1.60; 95% CI=1.28, 2.00); and functional disability (OR=2.48; 95% CI=1.96, 3.15).Conclusion: The 12-month prevalence and odds of major depression are high in individuals with chronic medical conditions, and major depression is associated with significant increases in utilization, lost productivity and functional disability. (C) 2007 Elsevier Inc. All rights reserved.