Applicability of systematic screening for signs and symptoms of depression in family practice patients in Slovenia.

D. Kozel, J. Zakotnik, A. T. Grum, J. Kersnik, D. Pavlič, M. Tomori, S. Ziherl
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引用次数: 2

Abstract

Background: The prevalence of depression in primary care setting is high. About a half of patients with depression remain undetected. The aim of our study was to determine whether screening questionnaires assist family practitioners in identifying more patients with depression. Methods: The multicentric study included 25 medical teams (a family practitioner and a nurse) from several Slovenian regions and 2,328 patients (86 % of all patients who were asked to participate) above 18 years of age, who had not been treated for mental disorders and who during the study visited their family practitioners for different medical problems. The study was divided into two phases, which lasted three consecutive hours daily over a period of ten working days. In the first phase, the family practitioners recorded the number of new diagnoses of depression. Six weeks later, patients completed the Zung Self-Rating Depression Scale (ZSRDS) in the waiting room. At the same time, family practitioner used the Patient Health Questionnaire 9 (PHQ-9) to screen depression symptoms. Results: In the first phase, depression was diagnosed in 5.7 % participating patients, and in the second phase, 10.9 % of patients on ZSRDS or 9.6 % on PHQ-9 exceeded the cut-off score. The difference was statistically significant in ZSRDS (p < 001). Patients with positive screening results were mostly women – 16.9 % (PHQ-9) or 18.8 % (ZSRDS), and patients with chronic condition – 22.0 % (PHQ-9) or 23.3 % (ZSRDS), both in age groups from 46 to 55 years. The family practitioners treated 94.6 % (PHQ-9) or 71.3 % (ZSRDS) of people with positive screening results. Conclusions: Results of both screening questionnaires were comparable. The screening tools can help family physicians in more efficientBackground: The prevalence of depression in primary care setting is high. About a half of patients with depression remain undetected. The aim of our study was to determine whether screening questionnaires assist family practitioners in identifying more patients with depression. Methods: The multicentric study included 25 medical teams (a family practitioner and a nurse) from several Slovenian regions and 2,328 patients (86 % of all patients who were asked to participate) above 18 years of age, who had not been treated for mental disorders and who during the study visited their family practitioners for different medical problems. The study was divided into two phases, which lasted three consecutive hours daily over a period of ten working days. In the first phase, the family practitioners recorded the number of new diagnoses of depression. Six weeks later, patients completed the Zung Self-Rating Depression Scale (ZSRDS) in the waiting room. At the same time, family practitioner used the Patient Health Questionnaire 9 (PHQ-9) to screen depression symptoms. Results: In the first phase, depression was diagnosed in 5.7 % participating patients, and in the second phase, 10.9 % of patients on ZSRDS or 9.6 % on PHQ-9 exceeded the cut-off score. The difference was statistically significant in ZSRDS (p < 001). Patients with positive screening results were mostly women – 16.9 % (PHQ-9) or 18.8 % (ZSRDS), and patients with chronic condition – 22.0 % (PHQ-9) or 23.3 % (ZSRDS), both in age groups from 46 to 55 years. The family practitioners treated 94.6 % (PHQ-9) or 71.3 % (ZSRDS) of people with positive screening results. Conclusions: Results of both screening questionnaires were comparable. The screening tools can help family physicians in more efficient identification of depression. Targeted screening in high-risk groups, women and chronic patients in the age group from 46 to 55 years, would be reasonable.
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斯洛文尼亚家庭执业患者抑郁症症状和体征系统性筛查的适用性
背景:抑郁症在初级保健机构的患病率很高。大约一半的抑郁症患者仍未被发现。我们研究的目的是确定筛选问卷是否有助于家庭医生识别更多的抑郁症患者。方法:多中心研究包括来自斯洛文尼亚几个地区的25个医疗团队(一名家庭医生和一名护士)和2,328名年龄在18岁以上的患者(占所有被要求参与的患者的86%),他们没有接受过精神障碍治疗,并且在研究期间因不同的医疗问题拜访了他们的家庭医生。研究分为两个阶段,在10个工作日内每天连续进行3个小时。在第一阶段,家庭医生记录了新诊断的抑郁症的数量。6周后,患者在候诊室完成Zung抑郁自评量表(ZSRDS)。同时,家庭医生使用患者健康问卷9 (PHQ-9)筛查抑郁症状。结果:在第一阶段,5.7%的参与患者被诊断为抑郁症,在第二阶段,10.9%的ZSRDS患者或9.6%的PHQ-9患者超过了临界值。ZSRDS差异有统计学意义(p < 001)。筛查结果阳性的患者主要是女性(16.9% (PHQ-9)或18.8% (ZSRDS),慢性疾病患者- 22.0% (PHQ-9)或23.3% (ZSRDS),年龄均为46至55岁。家庭医生治疗了94.6% (PHQ-9)或71.3% (ZSRDS)筛查结果阳性的人。结论:两种筛查问卷的结果具有可比性。背景:抑郁症在初级保健机构的患病率很高。大约一半的抑郁症患者仍未被发现。我们研究的目的是确定筛选问卷是否有助于家庭医生识别更多的抑郁症患者。方法:多中心研究包括来自斯洛文尼亚几个地区的25个医疗团队(一名家庭医生和一名护士)和2,328名年龄在18岁以上的患者(占所有被要求参与的患者的86%),他们没有接受过精神障碍治疗,并且在研究期间因不同的医疗问题拜访了他们的家庭医生。研究分为两个阶段,在10个工作日内每天连续进行3个小时。在第一阶段,家庭医生记录了新诊断的抑郁症的数量。6周后,患者在候诊室完成Zung抑郁自评量表(ZSRDS)。同时,家庭医生使用患者健康问卷9 (PHQ-9)筛查抑郁症状。结果:在第一阶段,5.7%的参与患者被诊断为抑郁症,在第二阶段,10.9%的ZSRDS患者或9.6%的PHQ-9患者超过了临界值。ZSRDS差异有统计学意义(p < 001)。筛查结果阳性的患者主要是女性(16.9% (PHQ-9)或18.8% (ZSRDS),慢性疾病患者- 22.0% (PHQ-9)或23.3% (ZSRDS),年龄均为46至55岁。家庭医生治疗了94.6% (PHQ-9)或71.3% (ZSRDS)筛查结果阳性的人。结论:两种筛查问卷的结果具有可比性。筛查工具可以帮助家庭医生更有效地识别抑郁症。在46至55岁的高危人群,妇女和慢性患者中进行有针对性的筛查是合理的。
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CiteScore
0.30
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发文量
65
审稿时长
4-8 weeks
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