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サービス利用と社会的な病気は,コミュニティにおけるうつ病症状と関連しています
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
まとめ
抑うつ症状は正式な障害ではないが,その高い流行により,医療サービスの利用と社会的障害が著しく増加する. これらのサブ臨床的症例に対処することは,公衆衛生にとって極めて重要です.
科学分野:
- エピデミオロジー エピデミオロジー
- 公衆衛生は公衆衛生である.
- メンタルヘルス・サービス 研究 メンタルヘルス・サービス
背景:
- 鬱病の症状は,コミュニティの中で非常に一般的です.
- これらの症状の社会的負担を理解することは,効果的な医療計画に不可欠です.
研究 の 目的:
- 鬱症状に関連したサービス利用率と社会的罹患率を推定する.
- 集団に起因するリスクの流行病学的測定法を適用する.
主な方法:
- 疫学調査を実施しました.
- アメリカ合衆国の5つのコミュニティで複合的なランダムサンプルから18,571人の成人をインタビューした (流行病学キャッチメントエリア研究).
- 自殺未遂,薬物使用,健康状態,職場欠勤,感情的問題に対する医療サービスの利用など,評価されたアウトカム.
主要な成果:
- 重度のうつ病-ジスティミア (6.1%の罹患率) とうつ病症状 (23.1%の罹患率) の両方が,サービス利用の増加と社会的罹患率と相関していました.
- 抑うつ症状は,緊急診療 (11.8%),診療 (21.5%),薬剤使用 (14.6%の鎮静剤,21.0%の睡眠薬,22.2%の抗うつ剤),自己報告の悪い感情的健康 (15.3%),失われた労働日 (17.8%),および自殺未遂 (25.0%) に関する人口の相当な割合を占めた.
- うつ病症状の高い流行は,診断されたうつ病障害と同等の,またはそれ以上の人口のレベルでのサービス負担をもたらしました.
結論:
- 医者は,診断されたうつ病障害よりも,うつ病症状のある個人に多くサービスを提供しています.
- サブクリニカルうつ病は,その高い罹患率のために,公衆衛生上の重要な課題を代表しています.
- サブ臨床的うつ症状の診断と治療に重点を置く必要がある.
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