PLOS ONE2013-11-17 1:13 AM

Burden of Depressive Disorders by Country, Sex, Age, and Year: Findings from the Global Burden of Disease Study 2010 受国家,性别,年龄和年份影响的抑郁疾病负担障碍:对2010年全球疾病负担研究的发现

Abstract GBD: 全球疾病负担:疾病负担(burden of disease)是疾病(disease)、伤残(disability)和过早死亡(premature death)对整个社会经济及健康的压力。 Background Depressive disorders were a leading cause of burden in the Global Burden of Disease (GBD) 1990 and 2000 studies. Here, we analyze the burden of depressive disorders in GBD 2010 and present severity proportions, burden by country, region, age, sex, and year, as well as burden of depressive disorders as a risk factor for suicide and ischemic heart disease. 背景 在1990和2000年的全球疾病负担(GBD)研究中,抑郁疾病被发现是造成疾病负担的主要原因之一。在这里我们分析了2010年全球疾病负担(GBD)研究中抑郁疾病的负担障碍,展示了负担障碍受国家,地区,年龄,性别和年份等因素影响以及受抑郁疾病影响的严重性的比例。其中抑郁疾病障碍是引起自杀和缺血性心脏病的高危因素之一。 Methods and Findings Burden was calculated for major depressive disorder (MDD) and dysthymia. A systematic review of epidemiological data was conducted. The data were pooled using a Bayesian meta-regression. Disability weights from population survey data quantified the severity of health loss from depressive disorders. These weights were used to calculate years lived with disability (YLDs) and disability adjusted life years (DALYs). Separate DALYs were estimated for suicide and ischemic heart disease attributable to depressive disorders. 方法和发现 负担障碍包括重度抑郁障碍(MDD)和心境恶劣障碍。我们对流行病学数据进行了系统的审查,且在审查中使用了贝叶斯偏回归分析方法来抽取数据。从人口调查数据中得到的失能权重符合抑郁疾病造成的健康损害严重程度。这些权重被用来计算失能寿命损失年(YLDs)和失能调整生命年(DALYs)。独立的失能调整生命年(DALYs)被考虑和预估进引起抑郁疾病的自杀和心境恶劣障碍疾病之中。 Depressive disorders were the second leading cause of YLDs in 2010. MDD accounted for 8.2% (5.9%–10.8%) of global YLDs and dysthymia for 1.4% (0.9%–2.0%). Depressive disorders were a leading cause of DALYs even though no mortality was attributed to them as the underlying cause. MDD accounted for 2.5% (1.9%–3.2%) of global DALYs and dysthymia for 0.5% (0.3%–0.6%). There was more regional variation in burden for MDD than for dysthymia; with higher estimates in females, and adults of working age. Whilst burden increased by 37.5% between 1990 and 2010, this was due to population growth and ageing. MDD explained 16 million suicide DALYs and almost 4 million ischemic heart disease DALYs. This attributable burden would increase the overall burden of depressive disorders from 3.0% (2.2%–3.8%) to 3.8% (3.0%–4.7%) of global DALYs. 抑郁疾病是造成2010年失能寿命损失年(YLDs)的第二大主要因素。重度抑郁障碍疾病(MDD)占全球失能寿命损失年(YLDs)的8.2%(5.9%-10.8%),心境恶劣障碍疾病占1.4%(0.9%-2.0%)。即使抑郁疾病基本不会导致死亡,它仍是造成失能调整生命年(DALYs)的主要原因之一。重度抑郁障碍疾病(MDD)占全球失能寿命损失年(DALYs)的2.5%(1.9%-3.2%),心境恶劣障碍疾病占0.5%(0.3%-0.6%)。重度抑郁障碍疾病(MDD)的区域性变化比心境恶劣障碍疾病的更大;集中在女性和工作年龄层的成年人中出现的机率更高。同时由于人口的增长和老龄化,负担障碍在1990年与2010年间增加了37.5%。重度抑郁障碍疾病(MDD)解释了1600万失能调整生命年(DALYs)自杀例子的原因和几乎400万失能调整生命年(DALYs)缺血性心脏病例子的原因。归因于这些的负担障碍可能引起全球范围失能调整生命年(DALYs)中抑郁性疾病整体障碍从3.0%(2.2%-3.8%)增长到3.8%(3.0%-4.7%)。 Conclusions GBD 2010 identified depressive disorders as a leading cause of burden. MDD was also a contributor of burden allocated to suicide and ischemic heart disease. These findings emphasize the importance of including depressive disorders as a public-health priority and implementing cost-effective interventions to reduce its burden. 结论 2010年的全球疾病负担(GBD)研究确定抑郁疾病是造成负担障碍的主要原因。重度抑郁障碍疾病(MDD)也是造成自杀和缺血性心脏病的负担障碍的原因之一。这些发现强调了将抑郁疾病障碍纳入公共健康优先权和实施‘成本-效益’干预来降低负担障碍的重要性。

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