Detection and management of depression in adult primary care patients in Hong Kong: a cross-sectional survey conducted by a primary care practice-based research network
Detection and management of depression in adult primary care patients in Hong Kong: a cross-sectional survey conducted by a primary care practice-based research network
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DOI：
10.1186/1471-2296-15-30
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发表时间：
2014-02-12
影响因子：
2.9
通讯作者：
Chiu, Billy C. F.
中科院分区：
文献类型：
--
作者：
Chin, Weng Yee;Chan, Kit T. Y.;Chiu, Billy C. F.
背景资料：本研究旨在探讨基层医疗抑郁症的患病率，危险因素，检出率和管理在香港。方法：一个横断面调查，其中包含PHQ-9仪器进行了候诊室病人的59个基层医疗医生。不知道PHQ-9评分的医生报告了他们是否认为他们的患者患有抑郁症以及他们的管理。PHQ-9筛查阳性率为10.7%（95%CI：9.7%-11.7%）。使用多变量分析，PHQ-9阳性的风险因素包括：女性;年龄= 2个合并症;有精神疾病家族史;有抑郁症或其他精神疾病的既往史。总体而言，23.1%的PHQ-9阳性患者被医生诊断为抑郁症。被诊断为抑郁症的预测因素包括：PHQ-9评分较高;既往有抑郁症或其他精神健康问题史;女性;年龄≥ 35岁;退休或家庭主妇;非中国人;没有定期运动;最近一个月内看过医生;有精神健康问题家族史;在被诊断为抑郁症的患者中，43%的人服用抗抑郁药，11%的人服用苯二氮卓类药物，42%的人接受咨询，9%的人被转介，最常见的是咨询师。大约十分之一的初级保健患者对抑郁症的筛查呈阳性，其中大约四分之一的医生诊断为抑郁症。患抑郁症的风险最大的是有抑郁症病史的患者，失业者或患有多种疾病的患者。最有可能被医生诊断为抑郁症的患者是那些有抑郁症病史或有严重抑郁症症状的人。中国患者被诊断出患有抑郁症的可能性是非中国患者的一半。超过一半被诊断患有抑郁症的患者接受药物治疗。
Background: This study aimed to examine the prevalence, risk factors, detection rates and management of primary care depression in Hong Kong.Methods: A cross-sectional survey containing the PHQ-9 instrument was conducted on waiting room patients of 59 primary care doctors. Doctors blinded to the PHQ-9 scores reported whether they thought their patients had depression and their management.Results: 10,179 patients completed the survey (response rate 81%). The prevalence of PHQ-9 positive screening was 10.7% (95% CI: 9.7%-11.7%). Using multivariate analysis, risk factors for being PHQ-9 positive included: being female; aged = two co-morbidities; having a family history of mental illness; and having a past history of depression or other mental illness. Overall, 23.1% of patients who screened PHQ-9 positive received a diagnosis of depression by the doctor. Predictors for receiving a diagnosis of depression included: having higher PHQ-9 scores; a past history of depression or other mental health problem; being female; aged >= 35 years; being retired or a homemaker; being non-Chinese; having no regular exercise; consulted a doctor within the last month; having a family history of mental health problems; and consulted a doctor in private practice.In patients diagnosed with depression, 43% were prescribed antidepressants, 11% were prescribed benzodiazepines, 42% were provided with counseling and 9% were referred, most commonly to a counselor.Conclusion: About one in ten primary care patients screen positive for depression, of which doctors diagnose depression in approximately one in four. At greatest risk for depression are patients with a past history of depression, who are unemployed, or who have multiple illnesses. Patients most likely to receive a diagnosis of depression by a doctor are those with a past history of depression or who have severe symptoms of depression. Chinese patients are half as likely to be diagnosed with depression as non-Chinese patients. Over half of all patients diagnosed with depression are treated with medications.