Reducing the global burden of depression

作者：Dan Chisholm, Kristy A. Sanderson, José Luís Ayuso‐Mateos, Shekhar Saxena · 发表于：The British Journal of Psychiatry · 年份：2004 · DOI：10.1192/bjp.184.5.393 · 被引用次数：376 · 研究领域：Mental Health Treatment and Access、Treatment of Major Depression、Health Systems, Economic Evaluations, Quality of Life

BACKGROUND: International evidence on the cost and effects of interventions for reducing the global burden of depression remain scarce. Aims To estimate the population-level cost-effectiveness of evidence-based depression interventions and their contribution towards reducing current burden. METHOD: Primary-care-based depression interventions were modelled at the level of whole populations in 14 epidemiological subregions of the world. Total population-level costs (in international dollars or I$) and effectiveness (disability adjusted life years (DALYs) averted) were combined to form average and incremental cost-effectiveness ratios. RESULTS: Evaluated interventions have the potential to reduce the current burden of depression by 10-30%. Pharmacotherapy with older antidepressant drugs, with or without proactive collaborative care, are currently more cost-effective strategies than those using newer antidepressants, particularly in lower-income subregions. CONCLUSIONS: Even in resource-poor regions, each DALYaverted by efficient depression treatments in primary care costs less than 1 year of average per capita income, making such interventions a cost-effective use of health resources. However, current levels of burden can only be reduced significantly if there is a substantial increase substantial increase in treatment coverage.