Prevalence of dysthymic disorder in primary care
Prevalence of dysthymic disorder in primary care
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DOI：
10.1016/s0165-0327(98)00189-x
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发表时间：
1999-08-01
影响因子：
6.6
通讯作者：
Dunn, E
中科院分区：
文献类型：
--
作者：
Browne, G;Steiner, M;Dunn, E
背景：心境恶劣障碍的特征是一种慢性抑郁情绪状态，不能归因于身体、心理或社会事件。虽然它可以单独发生，但越来越多的证据表明，大多数符合恶劣心境障碍标准的个体在其一生中也会经历更严重的发作性情绪障碍，并且在其家庭成员中也存在情绪障碍的聚集性。心境恶劣障碍患者最常见于初级保健。一些研究人员认为，这些人中的大多数从未被诊断出来，或者直到出现更严重的发作性情绪障碍才被诊断出来。本研究的目的是确定在加拿大安大略省的一个初级保健卫生服务组织中，轴I精神障碍，特别是心境恶劣障碍的12个月患病率。方法：在初级保健卫生服务组织登记的符合条件和同意的成年人使用修改后的密歇根大学综合国际诊断访谈表进行筛选。结果：在6280名符合条件的受试者中，4327名（69%）同意筛查。222名（5.1%）受试者筛查为心境恶劣障碍阳性。此外，90%的心境恶劣障碍筛查阳性的患者在其他I轴障碍筛查中也呈阳性，包括重度抑郁症、恐慌症、单纯性恐惧症和广泛性焦虑症。结论：初级保健医生在识别和治疗恶劣心境障碍及相关轴I障碍方面发挥关键作用的潜力很大。鉴于恶劣心境障碍在家庭中的聚集性报道，将家庭作为护理单位的重点可能特别重要。(C) 1999 Elsevier Science B.V.版权所有
Background: Dysthymic disorder is characterised as a chronic state of depressed mood which is not otherwise attributable to physical, psychological or social events. While it can occur alone, there is increasing evidence that the majority of individuals who meet criteria for dysthymic disorder also experience more severe episodic mood disorders throughout their lifetime, and there is also an aggregation of mood disorders within their family members. Patients with dysthymic disorder are most often seen in primary care. Some researchers suggest that the majority of these individuals are never diagnosed or are not diagnosed until a more severe episodic mood disorder develops. The objective of this study was to determine the 12-month prevalence of Axis I psychiatric disorders, and in particular dysthymic disorder, in a primary care Health Service Organization in Ontario, Canada. Methods: Eligible and consenting adults registered with a primary care Health Service Organization were screened using the modified form of the University of Michigan Composite International Diagnostic Interview. Results: Of the 6280 eligible subjects, 4327 (69%) consented to screening. Two hundred and twenty-two (5.1%) subjects screened positive for dysthymic disorder. In addition, 90% of those who screened positive for dysthymic disorder also screened positive for other Axis I disorders including major depressive disorder, panic, simple phobia, and generalized anxiety disorder. Conclusions: There is much potential for the primary care physician to play a pivotal role in the recognition and treatment of dysthymic disorder and associated Axis I disorders. A focus on the family as a unit for care may be especially important given the reported aggregation of dysthymic disorder within families. (C) 1999 Elsevier Science B.V. All rights reserved.