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發現與治療憂鬱症第一線--基層醫療診所

根據世界衛生組織的報告顯示,基層醫療門診病患中約有24%的人有精神疾病(以ICD-10為診斷標準),69%的精神疾病患者會以身體疾病作為主訴症狀向醫生求醫,50%的憂鬱症患者未被基層醫療單位診斷出來。世界衛生組織指出抗憂鬱劑及短程、結構式的心理治療對60∼80%至基層醫療診所求診且受憂鬱症困擾的民眾有效,然而卻只有不到25%(有些國家甚至低於10%)的憂鬱症基層求診患者接受到有效的治療,主要原因在於投入資源不足、基層醫療人員缺乏訓練及社會對憂鬱症污名化看法的影響。

出處1:European Region of World Health Organization (2005).Access to Good Primary Care in Mental Health.
出處2:European Region of World Health Organization (2005). What are the most effective diagnostic and therapeutic strategies for the management of depression in specialist care?
出處3:World Health Organization(2005) http://www.who.int/mental_health/management/depression/definition/en/

 

原文1:In a World Health Organization (WHO) study of 15 facilities across the world, the prevalence of mental disorders (as defined in the Tenth Revision of the International Classification of Diseases – ICD 10) among consecutive primary care attenders was 24% (2). In addition, people with mental disorders usually present to primary care physicians with physical symptoms. In this study, 69% of patients with mental disorders presented in this way.

原文2:In several countries it has been reported that as many as 50% of depression cases go unrecognized in primary care settings

原文3:

  1. Depression can be reliably diagnosed and treated in primary care.
  2. Fewer than 25 % of those affected have access to effective treatments.

Depression can be reliably diagnosed in primary care. Antidepressant medications and brief, structured forms of psychotherapy are effective for 60-80 % of those affected and can be delivered in primary care. However, fewer than 25 % of those affected (in some countries fewer than 10 %) receive such treatments. Barriers to effective care include the lack of resources, lack of trained providers, and the social stigma associated with mental disorders including depression.

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