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Epidémiologie de la dépression : données récentes I. Epidémiologie descriptive

Published online by Cambridge University Press:  28 April 2020

G. Bertschy
Affiliation:
Service de psychiatrie, hôpital Saint-Jacques, 2, place Saint-Jacques, 25030Besançon Cedex
S. Vandel
Affiliation:
Service de pharmacologie clinique, hôpital Jean-Minjoz, boulevard Fleming, 25030Besançon Cedex
R. Volmat
Affiliation:
Service de psychiatrie, hôpital Saint-Jacques, 2, place Saint-Jacques, 25030Besançon Cedex, France
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Résumé

Les auteurs font la revue des études récentes concernant l’épidémiologie de la dépression. Les études épidémiologiques de la dépression dans la population générale sont difficiles à interpréter, du fait de différences dans l'identification des cas et de variations dans les procédures de diagnostic entre les études. Mais il y a eu un progrés considérable avec le récent développement des méthodes d’identifications de cas, fiables et valides, comme les RDC et le DSM-III. D’autres problémes méthodologiques concernent le choix de la population et le choix des différentes mesures du risque.

Des données examinées, on peut tirer les estimations suivantes : la prévalence sur six mois de la dépression majeure est de 1% à 3% chez l’homme, et 3% à 5% chez la femme; la prévalence sur la vie entiere (proportion des sujets qui ont déjà présenté le trouble) est de 3% à 6% chez l’homme et 5% à 10% chez la femme. L’estimation du risque morbide (ou risque sur la vie entiére) est plus difficile. Le principal probléme provient de l’effet de cohorte de naissance: il semble que les taux de troubles affectifs majeurs sont en train d’augmenter dans les cohortes nées apres la Seconde Guerre mondiale.

Aussi, les auteurs proposent une estimation des risques sur la vie entiére qui ne peut être que prudente: 6 à 10% chez l’homme, 12 à 20% chez la femme. Ils envisagent aussi l’épidemiologie de la dépression sous l’angle de la mortalité: les troubles affectifs sont associés non seulement à un haut risque de suicide mais aussi à une mortalité générale augmentée.

Summary

Summary

The authors review recent epidemiotogical studies of depression, which are difficull to interpret in Ihe general population because of different case definitions and variations in diagnostic procedures from one study to the next. Considerable progress has been made with the recent development of reliable and valid methods of case identification such as the RDC and the DSM III. Other methodological problems concern the choice of populations and the different risk evaluations.

On the basis of the reviewed data, the following estimations can be made: the six-month prevalence of major depression is 1 to 3% for men and 3 to 5% for women; the lifetime prevalence (proportion of subjects having at one time sujfered from the disorder) is 3 to 6% for men and 5 to 10% for women. Lifetime risk estimation is more difficull. The main problem arises front the birth cohort effect: the rate of major affective disorders in the cohorts born after World War II seems to be increasing.

Thus, the authors propose a prudent lifetime risk estimation : 6 to 10% for men, and 12 to 20% for women. The epidemiology of depression is also examined in relation to mortality: affective disorders are associated not only with a high suicide rate, but also with increased general mortality.

Type
Revue
Copyright
Copyright © European Psychiatric Association 1988

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