Global Burden Disease Estimates for Major Depressive Disorders (MDD): A review of diagnostic instruments used in studies of prevalence.

IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Community Mental Health Journal Pub Date : 2024-11-01 Epub Date: 2024-07-01 DOI:10.1007/s10597-024-01302-6
Lisa Cosgrove, Petra Brhlikova, Rosanna Lyus, Farahdeba Herrawi, Gianna D'Ambrozio, Elia Abi-Jaoude, Allyson M Pollock
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Abstract

Global Burden of Disease (GBD) estimates have significant policy implications nationally and internationally. Disease burden metrics, particularly for depression, have played a critical role in raising governmental awareness of mental health and in calculating the economic cost of depression. Recently, the World Health Organization ranked depression as the single largest contributor to global disability. The main aim of this paper was to assess the basis upon which GBD prevalence estimates for major depressive disorder (MDD) were made. We identify the instruments used in the 2019 GBD estimates and provide a descriptive assessment of the five most frequently used instruments. The majority of country studies, 356/566 (62.9%), used general mental health screeners or structured/semi-structured interview guides, 98/566 (17.3%) of the studies used dedicated depression screeners, and 112 (19.8%) used other tools for assessing depression. Thus, most of the studies used instruments that were not designed to make a diagnosis of depression or assess depression severity. Our results are congruent with and extend previous research that has identified critical flaws in the data underpinning the GBD estimates for MDD. Despite the widespread promotion of these prevalence estimates, caution is needed before using them to inform public policy and mental health interventions. This is particularly important in lower-income countries where resources are scarce.

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重度抑郁症(MDD)的全球疾病负担估算:流行率研究中使用的诊断工具回顾。
全球疾病负担(GBD)估算对国家和国际政策具有重大影响。疾病负担指标,尤其是抑郁症的疾病负担指标,在提高政府对心理健康的认识和计算抑郁症的经济成本方面发挥了至关重要的作用。最近,世界卫生组织将抑郁症列为导致全球残疾的最大因素。本文的主要目的是评估 GBD 对重度抑郁障碍(MDD)患病率估计的依据。我们确定了 2019 年 GBD 估算中使用的工具,并对最常用的五种工具进行了描述性评估。大多数国家的研究(356/566,占 62.9%)使用了一般心理健康筛查工具或结构化/半结构化访谈指南,98/566(占 17.3%)的研究使用了专门的抑郁筛查工具,112(占 19.8%)的研究使用了其他抑郁评估工具。因此,大多数研究使用的工具并非用于诊断抑郁症或评估抑郁症的严重程度。我们的研究结果与之前的研究结果一致,并对之前的研究进行了扩展,这些研究发现,GBD 对 MDD 的估计值所依据的数据存在严重缺陷。尽管这些患病率估计值得到了广泛推广,但在使用它们为公共政策和心理健康干预提供信息之前仍需谨慎。这一点在资源匮乏的低收入国家尤为重要。
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来源期刊
CiteScore
5.30
自引率
3.70%
发文量
133
期刊介绍: Community Mental Health Journal focuses on the needs of people experiencing serious forms of psychological distress, as well as the structures established to address those needs. Areas of particular interest include critical examination of current paradigms of diagnosis and treatment, socio-structural determinants of mental health, social hierarchies within the public mental health systems, and the intersection of public mental health programs and social/racial justice and health equity. While this is the journal of the American Association for Community Psychiatry, we welcome manuscripts reflecting research from a range of disciplines on recovery-oriented services, public health policy, clinical delivery systems, advocacy, and emerging and innovative practices.
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