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Utilización de servicios y morbilidad social asociada con síntomas depresivos en la comunidad
J Johnson1, M M Weissman, G L Klerman
1Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY.
JAMA
|March 18, 1992
Resumen
Los síntomas depresivos, aunque no son un trastorno formal, aumentan significativamente el uso de los servicios de salud y el deterioro social debido a su alta prevalencia. Abordar estos casos subclínicos es crucial para la salud pública.
Área de la Ciencia:
- Epidemiología La epidemiología.
- Salud Pública La salud pública.
- Servicios de Salud Mental Investigación Investigación.
Sus antecedentes:
- Los síntomas depresivos son muy frecuentes en la comunidad.
- Comprender la carga social de estos síntomas es esencial para una planificación efectiva de la atención médica.
Objetivo del estudio:
- Para estimar la utilización de los servicios y la morbilidad social vinculada a los síntomas depresivos.
- Para aplicar la medida epidemiológica del riesgo atribuible a la población.
Principales métodos:
- Realizó una encuesta epidemiológica.
- Se entrevistó a 18.571 adultos de una muestra aleatoria compleja en cinco comunidades de los Estados Unidos (Estudio de Área de Captura Epidemiológica).
- Resultados evaluados que incluyen intentos de suicidio, uso de medicamentos, estado de salud, absentismo laboral y uso de servicios de atención médica para problemas emocionales.
Principales resultados:
- Tanto la depresión mayor-distimia (6.1% de prevalencia) como los síntomas depresivos (23.1% de prevalencia) se correlacionaron con el aumento del uso de servicios y la morbilidad social.
- Los síntomas depresivos representaron porcentajes de riesgo atribuibles a la población sustancial para el uso del departamento de emergencias (11,8%), consultas médicas (21,5%), uso de medicamentos (tranquilizantes 14,6%, pastillas para dormir 21,0%, antidepresivos 22,2%), mala salud emocional autoinformada (15,3%), días de trabajo perdidos (17,8%) e intentos de suicidio (25,0%).
- La alta prevalencia de síntomas depresivos resultó en una carga de servicio a nivel de población comparable o superior a la de los trastornos depresivos diagnosticados.
Conclusiones:
- Los médicos atienden a más personas con síntomas depresivos que a los trastornos depresivos diagnosticados.
- La depresión subclínica representa un desafío significativo para la salud pública debido a su alta prevalencia.
- Hay una necesidad de centrarse en el diagnóstico y tratamiento de los síntomas depresivos subclínicos.
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