LA EPIDEMIOLOGÍA DEL TRASTORNO DEPRESIVO MAYOR EN EL ESTUDIO NACIONAL DE SALUD MENTAL, COLOMBIA 2003
Palabras clave:
Salud mental, trastornos mentales, depresión, prevalencia, Colombia, Mental health, mental disorders, depression prevalenceResumen
ResumenIntroducción: Faltan datos epidemiológicos en relación con la prevalencia, factores potenciales de riesgo y predictores de tratamiento en el trastorno depresivo mayor.
Objetivo. Este estudio se realizó para hacer una estimación de la prevalencia de la depresión, los factores de riesgo asociados y los predictores de tratamiento obtenidos a partir de la base de datos del Estudio nacional de salud mental, Colombia 2003 (ENSM), realizado como parte de la Encuesta Mundial de Salud Mental (WMHS por sus siglas en inglés) de la Organización Mundial de la Salud, la Universidad de Harvard y la Universidad de Michigan.
Material y Métodos. Se llevó a cabo una encuesta de hogares, a 4.426 adultos de 60 municipios representativos del país. Las principales mediciones de resultados incluyen la prevalencia y correlación del Trastorno Depresivo Mayor (TDM) utilizando la Entrevista Diagnóstica Internacional Compuesta de la Organización Mundial de la Salud (CIDI por sus siglas en inglés), la severidad evaluada en los últimos 12 meses con el Inventario Rápido de Sintomatología Depresiva Auto –Reportada y con la Escala de Discapacidad de Sheehan.
Resultados. La prevalencia de vida fue de 13,3% y en los últimos 12 meses fue del 6,2%.
Todos los casos en los últimos 12 meses, se clasificaron de forma independiente como clínicamente significativos: 15,3% leves, 33,0% moderados, 34,9% graves, y 14,1% muy graves. La duración media del episodio depresivo fue 30,85 semanas.
Discusión. El trastorno depresivo mayor, generalmente se asocia con severidad de los síntomas y deterioro del desempeño; Si bien el incremento en la atención es alentador, el tratamiento inadecuado constituye una preocupación importante. Se debe enfatizar en el diagnóstico para la identificación precoz de los casos y el inicio temprano del tratamiento y se debe hacer un esfuerzo mayor en la accesibilidad de la calidad de las intervenciones.
Palabras clave: Salud mental, trastornos mentales, depresión, prevalencia, Colombia.
MAJOR DEPRESSIVE DISORDER EPIDEMIOLOGY: COLOMBIAN MENTAL HEALTH NATIONAL STUDY, 2003
AbstractIntroduction. Epidemiological data is scarse regarding prevalence, potential risk factors and treatment predictors for major depressive disorder (MDD).
Objective. The present study was designed to make an estimate of the prevalence of depression, associated potential risk factors and treatment predictors, from the National Study of Mental Health, Colombia 2003, carried out as part of the WHO´s World Mental Health (WMH) Survey Initiative.
Material and methods. A face-to-face household community survey in 4.426 adults was undertaken in 60 representative municipalities of the country. Main outcome measures included prevalence and correlates of MDD using the World Health Organization’s (WHO) Composite International Diagnostic Interview (CIDI), 12-month severity with the Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR) and the Sheehan Disability Scale (SDS).
Results. Prevalence of CIDI MDD for lifetime was 13.3% and for 12-month was 6.2%. Virtually all CIDI 12-month cases were independently classified as clinically significant using the QIDS-SR, with 15.3% mild, 33.0% moderate, 34.9% severe, and 14.1% very severe. Mean episode duration was 30.85 weeks. Role impairment as measured by SDS was substantial as indicated by 50.3% of 12-month cases with severe or very severe role impairment. Most 12-month (63.6%) cases had comorbid CIDI/ DSM-IV disorders, with MDD only rarely primary. Sociodemographic correlates of treatment were far less numerous than those of prevalence.
Discussion. Major depressive disorder is common, widely distributed, usually associated with symptom severity and role impairment. While the increase in treatment is encouraging, inadequate treatment is a serious concern. Screening, early identification of cases and treatment initiation needs to be emphasized. Treatment and intervention quality improvement should be pursuit.
Key words: Mental health, mental disorders, depression prevalence, Colombia.
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