Medical disorders affect health outcome and general functioning depending on comorbid major depression in the general population
Medical disorders affect health outcome and general functioning depending on comorbid major depression in the general population
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DOI：
10.1016/j.jpsychores.2006.09.014
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发表时间：
2007-02-01
影响因子：
4.7
通讯作者：
Jacobi, Frank
中科院分区：
文献类型：
--
作者：
Baune, Bernhard T.;Adrian, Ina;Jacobi, Frank
目的：本研究的目的是比较健康相关的生活质量（HR-QoL），残疾/工作生产力，和医疗保健利用的各种医学疾病与和没有共病的重性抑郁症（MDD）的一般人群。方法：在4181名社区样本参与者中确定为期12个月的MDD（复合国际诊断访谈）诊断。在医学检查后进行医学诊断（呼吸系统、心血管、过敏、内分泌/代谢、胃肠道和神经系统疾病）。采用MOS-SF-36评价HR-QoL。门诊医生访问和残疾/工作效率进行了评估的自我报告。结果如下：在所有医学诊断中，合并MDD与SF-36精神总分较低相关，在合并过敏性和神经系统疾病中与身体总分较低相关。在没有抑郁症共病的病例中，并存的医学疾病的数量与较低的身体和精神总分密切相关。当存在任何没有合并MDD的医学疾病时，门诊医生就诊的数量增加了42%，合并MDD与进一步增加24-42%相关，这取决于医学疾病。共病MDD与较低的全职工作状态密切相关（37.1%伴MDD vs 51.0%不伴MDD），并且在存在任何医学疾病的情况下，与残疾天数显著增加（45%）密切相关。结论：研究结果对诊断和治疗程序有影响，并与未来研究中医学疾病数量的重要性有关。(c)2007爱思唯尔公司All rights reserved.
Objective: The objective of this study was to compare health-related quality of life (HR-QoL), disability/work productivity, and health care utilization in a variety of medical disorders with and without comorbid major depressive disorder (MDD) in the general population. Methods: Twelve-month MDD (Composite International Diagnostic Interview) diagnosis was determined among 4181 participants from a community sample. Medical diagnoses (respiratory, cardiovascular, allergic, endocrine/metabolic, gastrointestinal, and neurological diseases) were made after medical examination. HR-QoL was evaluated with the MOS-SF-36. Outpatient doctor visits and disability/work productivity were assessed by self-report. Results: Comorbid MDD was associated with a lower SF-36 mental summary score in all medical diagnoses and with a lower physical summary score in comorbid allergic and neurological disorders. The number of coexisting medical disorders was strongly related to lower physical and mental summary scores in cases without comorbid depression. The number of outpatient doctor visits increased by 42% when any of the medical disorders without comorbid MDD was present, and comorbid MDD was associated with a further 24-42% increase, depending on the medical disorder. Comorbid MDD was strongly associated with lower full-time working status (37.1% with MDD vs. 51.0% without MDD) and with a significant increase in disability days (45%) in the presence of any medical disorder. Conclusions: Findings have consequences for diagnostic and treatment procedures, as well as in relation to the importance of the number of medical disorders in future studies. (c) 2007 Elsevier Inc. All rights reserved.