Psychosocial wellbeing and psychiatric care in the European Communities: analysis of macro indicators
Psychosocial wellbeing and psychiatric care in the European Communities: analysis of macro indicators
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DOI：
10.1007/s00127-004-0871-0
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发表时间：
2004-11-01
影响因子：
4.4
通讯作者：
Xavier, M
中科院分区：
文献类型：
--
作者：
Carta, MG;Kovess, V;Xavier, M
背景本文报告了对从欧洲机构来源定期收集的几个宏观指标进行分析比较的结果。方法：我们进行了审查的宏观指标，能够提供一个综合的精神健康状况和精神病护理在欧洲国家的可用性的描述。这些数据是从世卫组织、经合组织、欧统局和国际监测系统等来源定期收集的。对每个国家的时间趋势进行评价，可以随后在国家之间进行比较。结果除爱尔兰和西班牙（部分）外，所有欧洲国家的自杀率在1980 - 2000年期间均呈下降趋势。在爱尔兰，这种增加的趋势特别强烈，年轻和成年男性的风险很高。葡萄牙和希腊的不明原因死亡率分别最高和最低。大多数国家在观察初期酒精消费量高，直到1980年，其比率都高于全国平均数，此后消费量下降。1960年，大多数低消费国家的消费率低于平均水平，直到1980年，消费率逐渐上升。然而，在所有国家，与酒精有关的死亡普遍减少。与精神障碍有关的死亡率增加，在1980年代中期最为明显。每10万居民中精神科医生的数量从西班牙的3.6到芬兰的17.5不等;儿童精神科医生的数量从德国的0.9到葡萄牙的5.1不等。精神病病床从意大利和西班牙的每1 000名居民0.4张到爱尔兰的1.3张不等。9个国家显示出减少精神病病床的趋势，而在另外5个国家没有观察到变化。长期住院患者的比例从英国的9.5到比利时的84不等，总体呈下降趋势。门诊设施的使用情况在各国之间有很大差异，尽管随着时间的推移总体上有所增加。关于精神药物销售的官方数据很少。IMS数据显示，所有欧洲国家的抗抑郁药和抗精神病药消费量都在增加。欧洲国家现有的官方数据资源似乎显示出一些差异，可能与记录方法有关。需要更好地协调欧洲联盟精神健康状况数据的收集工作，并提高现有服务的质量。
Background This paper reports the findings of an analytical comparison of several macro indicators collected routinely from institutional sources in Europe. Methods We carried out a review of macro indicators capable of providing a synthetic description of mental health status and the availability of psychiatric care in European countries. These were collected routinely from sources such as WHO, OECD, EUROSTAT, and IMS. The evaluation of temporal trends in each nation permits subsequent comparisons between countries. Results In all European countries, a decreased trend of suicides was observed in the period 1980 - 2000, with the exception of Ireland and ( partially) of Spain. In Ireland, the increased trend was particularly strong, with a high risk in young and adult males. Portugal and Greece had respectively the highest and the lowest rates of undetermined causes of death. Most countries that were high consumers of alcohol in the initial period of observation had a rate above the national mean until 1980, after which consumption decreased. Most nations that were low consumers in 1960 had rates below the mean until 1980, when the rates progressively increased. However, a general decrease of alcohol-related deaths was apparent in all countries. Mortality associated with mental disorder increased, most clearly during the mid 1980s. The number of psychiatrists per 100,000 inhabitants ranged from 3.6 in Spain to 17.5 in Finland; of child psychiatrists, from 0.9 in Germany to 5.1 in Portugal. Psychiatric beds ranged from 0.4 per 1,000 inhabitants in Italy and Spain to 1.3 in Ireland. Nine countries showed a trend towards a reduction in psychiatric beds, whilst in a further five countries no change was observed. Rates of long-stay patients varied from 9.5 in the UK to 84 in Belgium, with a generally decreasing trend. The use of outpatient facilities differed markedly between countries, although there was a general increase over time. Official data were scarce in relation to the sale of psychotropic drugs. IMS data indicated increasing consumption in all European countries for antidepressant and antipsychotic medication. Conclusions The official data resources available for European countries seem to indicate some discrepancies, probably relating to methods of recording. Better co-ordination in the collection of data about mental health status in the European Union and an improvement of the quality in available services is needed.