Late-life depression in Peru, Mexico and Venezuela: the 10/66 population-based study
Late-life depression in Peru, Mexico and Venezuela: the 10/66 population-based study
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DOI：
10.1192/bjp.bp.109.064055
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发表时间：
2009-12-01
影响因子：
10.5
通讯作者：
Prince, Martin
中科院分区：
文献类型：
--
作者：
Guerra, Mariella;Ferri, Cleusa P.;Prince, Martin
背景全球60岁及以上人口的比例正在增加，拉丁美洲的比例高于其他任何区域。抑郁症是常见的老年人和残疾的一个重要原因worldwide.AimsTo估计的患病率和相关的晚年抑郁症，相关的残疾和获得治疗在五个地点在Latin America.MethodA一个阶段的横断面调查5886人年龄在65岁及以上的城市和农村地区在秘鲁和墨西哥和城市网站在委内瑞拉。根据DSM-IV和ICD-10标准、老年精神状态-计算机辅助老年分类自动检查（GMS-AGECAT）算法和EURO-D截断点确定抑郁症。Poisson回归被用来估计社会人口学特征、经济状况和健康状况与ICD-10 depression. ResultsDSM-IV抑郁症的总体患病率在1.3%和2.8%之间变化，ICD-10抑郁发作在4.5%和5.1%之间，GMS-AGECAT抑郁症的患病率在30.0%和35.9%之间，EURO-D抑郁症的患病率在26.1%和31.2%之间，因此，临床显著抑郁症的患病率超过了ICD-10和DSM-IV诊断标准。大多数老年抑郁症患者从未接受过治疗。限制身体损伤和抑郁症的过去的历史是两个最一致的ICD-10抑郁epission.ConclusionsThe治疗差距构成了一个重大的挑战，拉丁美洲的卫生系统，其相对薄弱的初级保健服务和依赖私人专科医生，当地的治疗试验可以建立在政府部门的心理健康投资的成本效益。
BackgroundThe proportion of the global population aged 60 and over is increasing, more so in Latin America than any other region. Depression is common among elderly people and an important cause of disability worldwide.AimsTo estimate the prevalence and correlates of late-life depression, associated disability and access to treatment in five locations in Latin America.MethodA one-phase cross-sectional survey of 5886 people aged 65 and over from urban and rural locations in Peru and Mexico and an urban site in Venezuela. Depression was identified according to DSM-IV and ICD-10 criteria, Geriatric Mental State-Automated Geriatric Examination for Computer Assisted Taxonomy (GMS-AGECAT) algorithm and EURO-D cut-off point. Poisson regression was used to estimate the independent associations of sociodemographic characteristics, economic circumstances and health status with ICD-10 depression.ResultsFor DSM-IV major depression overall prevalence varied between 1.3% and 2.8% by site, for ICD-10 depressive episode between 4.5% and 5.1%, for GMS-AGECAT depression between 30.0% and 35.9% and for EURO-D depression between 26.1% and 31.2%, therefore, there was a considerable prevalence of clinically significant depression beyond that identified by ICD-10 and DSM-IV diagnostic criteria. Most older people with depression had never received treatment. Limiting physical impairments and a past history of depression were the two most consistent correlates of the ICD-10 depressive episode.ConclusionsThe treatment gap poses a significant challenge for Latin American health systems, with their relatively weak primary care services and reliance on private specialists', local treatment trials could establish the cost-effectiveness of mental health investment in the government sector.