The effect of major depression on participation in preventive health care activities
The effect of major depression on participation in preventive health care activities
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DOI：
10.1186/1471-2458-9-87
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发表时间：
2009-03-25
影响因子：
4.5
通讯作者：
Eliasziw, Michael
中科院分区：
文献类型：
--
作者：
Patten, Scott B.;Williams, Jeanne V. A.;Eliasziw, Michael
背景：本研究的目的是确定重度抑郁发作（MDE）是否有助于降低三种预防活动的参与率：血压检查、乳房x光检查和巴氏涂片检查。方法：本研究的数据来源是加拿大国家人口健康调查（NPHS），这是一项始于1994年的纵向研究，随后每两年对其参与者进行一次重新访谈。国家公共卫生服务包括一个简短的综合国际诊断访谈（CIDI-SF），以评估过去一年的MDE，并收集有关参与预防活动的数据。最初，我们检查了在特定年份患有MDE的受访者是否不太可能在同一年参加筛查。为了评估MDE是否消极地改变了参与模式，在1994年基线访谈中成功筛选的人被确定并根据其MDE状况分成队列。比例风险模型用于量化MDE对随后参与筛查的影响。结果：无论在横断面分析还是纵向分析中，均未发现MDE对参与三种预防活动的影响。对一组相关协变量进行调整并没有改变这一结果。结论：虽然MDE可能会减少参与筛查活动的频率，但在当前的分析中没有发现这方面的证据。由于MDE患者可能更频繁地接触卫生系统，这可能抵消疾病本身减少参与筛查的任何趋势。
Background: The objective of this study was to determine whether major depressive episodes (MDE) contribute to a lower rate of participation in three prevention activities: blood pressure checks, mammograms and Pap tests.Methods: The data source for this study was the Canadian National Population Health Survey (NPHS), a longitudinal study that started in 1994 and has subsequently re-interviewed its participants every two years. The NPHS included a short form version of the Composite International Diagnostic Interview (CIDI-SF) to assess past year MDE and also collected data on participation in preventive activities. Initially, we examined whether respondents with MDE in a particular year were less likely to participate in screening during that same year. In order to assess whether MDE negatively altered the pattern of participation, those successfully screened at the baseline interview in 1994 were identified and divided into cohorts depending on their MDE status. Proportional hazard models were used to quantify the effect of MDE on subsequent participation in screening.Results: No effect of MDE on participation in the three preventive activities was identified either in the cross-sectional or longitudinal analysis. Adjustment for a set of relevant covariates did not alter this result.Conclusion: Whereas MDE might be expected to reduce the frequency of participation in screening activities, no evidence for this was found in the current analysis. Since people with MDE may contact the health system more frequently, this may offset any tendency of the illness itself to reduce participation in screening.