摘要
目的比较首发与复发抑郁症患者的生活质量和卫生成本,为早期干预提供依据。方法对37例首发和21例复发抑郁症患者在入组后第3、6、12个月进行生活质量、疾病治疗的直接成本及疾病相关的间接成本的随访。以汉密尔顿抑郁量表17项（HAMD-17）和健康状况调查问卷（the short-form-36health survey,SF-36）分别评定患者疗效和生活质量。12个月随访结束时进行两组的生活质量与经济学比较。结果首发组SF-36的躯体功能和躯体疼痛情况好于复发组（P〈0.05）,其他因子两组无明显差异（P〉0.05）;复发组＂因病完全不能工作天数＂多于首发组（P=0.049）,＂能工作但效率下降天数＂明显多于首发组（P〈0.01）;②复发组的总成本绝对值、间接成本绝对值及间接成本所占比例均高于首发组（P〈0.01）,而两组直接成本绝对值的差异无统计学意义（P〉0.05）。复发组与首发组比较,人均每获得HAMD-17一个单位的疗效和SF-36一个单位生活质量的改善所需要的成本均高于首发组（539.2元vs294.7元;139.5~3839.2元vs70.6~1119.9元）。结论抑郁症的复发患者与首发患者相比,生活质量和劳动力受损更大,花费成本更多。
Objective To compare life quality and health costs in first-episode and recurrent outpatients with depression,thus providing evidence for early intervention.Methods 37 first-episode and 21 recurrent outpatients with depression were recruited and life quality,direct and indirect health related costs were evaluated at the 3rd,6th,and 12th month.The clinical status and life quality of patients were assessed using Hamilton depression scale-17 items（HAMD-17）and the Short-form-36 health survey（SF-36）.Results ① First-episode patients had better physical function and less physical pain in SF-36 than recurrent ones（P0.05）,while no difference were found for other SF-36 factors（P0.05）.Recurrent patients had more days of ＂incapacity to work＂,much more days of ＂low efficiency in work＂ than first-episode patients（P=0.049,P0.01）.②Total costs,indirect health-related costs,and proportion of indirect costs but not direct costs were higher in the recurrent group than in the first-episode group（P0.01）.Costs of effectiveness ratios were much higher in the recurrent group than that in the first-episode group in terms of costs of unit decrease in HAMD-17（RMB 539.2 vs 294.7）or unit increase in SF-36（RMB 139.5~3839.2 vs 70.6~1119.9）.Conclusions Patients with recurrent depression intend to have more severe impairment of quality of life,less productivity and higher health costs.
出处
《中国神经精神疾病杂志》
CAS
CSCD
北大核心
2010年第8期449-453,共5页
Chinese Journal of Nervous and Mental Diseases
关键词
抑郁症
生活质量
卫生成本
成本效果
Depression Quality of Life Health costs Cost effectiveness
