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<ul><li><p>( 3/2557)</p><p>Guidebook of Depressive DisordersSurveillance and Care : Provincial Level</p><p>(Revised Edition III ; 2014)</p><p> : </p></li><li><p> 2 </p><p> 20 </p><p> ,</p><p>HarvardSchoolofPublicHealth2563</p><p>24</p><p>10151.5</p><p> 1) 2 (2Q) </p><p>2)9(9Q)</p><p>3)8(8Q)4)</p><p>(CPG-MDD-GP)</p><p>5)</p><p> 6) </p><p> 2552-2556</p><p>2549</p><p>3.725561033.34</p><p>2563</p><p> 3</p></li><li><p> 1 5</p><p> 2 9</p><p> 2.1 9</p><p> 2.2 12</p><p> 2.3 13</p><p> 2.4 16</p><p> 2.5 18</p><p> 3 </p><p> 19</p><p> 3.1 19</p><p> 3.2 23</p><p> 3.3 28</p><p> 4 </p><p> 31</p><p> 4.1 31</p><p> 4.2 32</p><p> 4.3 32 </p><p> 4.4 33</p><p> 4.5 34</p><p> 4.6 35</p><p> 4.7 (Antidepressant) 36</p><p> 5 39</p><p> 6 41</p><p> 7 43</p><p> 7.1 43</p><p> 7.2 44</p><p> 7.3 45</p><p> 7.4 48</p><p> 7.5 49</p><p> 7.6 50</p><p> 7.7 52</p></li><li><p> . 55 </p><p> . 61</p><p> . 2 (2Q) 67</p><p> . 9 (9Q) 69</p><p> . 8 (8Q) 71</p><p> . ICD-10 73</p><p> . </p><p> 81</p><p> . 83</p><p> . 91</p><p> . 97</p><p> . 101</p><p> 1 16</p><p> 2 18</p><p> 3 Organic causes of a depressive symptoms 28</p><p> 4 Pharmacological causes of depression 29</p><p> 1 11</p><p> 2 12</p><p> 3 14</p></li><li><p> 5</p><p> 2547 (,</p><p>2552)(DisabilityAdjustedLifeYears,DALY)</p><p> 4 10 </p><p>135</p><p>1)</p><p> 2) </p><p>3)</p><p>4)</p><p>5)6)</p><p> 255115</p><p>1,311,797(MajorDepressiveEpisode)181,809</p><p>(Dysthymia)(2551)</p><p>1004</p><p>2546</p><p>4</p><p> 2549-2551</p><p> 1</p></li><li><p>6 </p><p>4//</p><p>106</p><p>.</p><p> 3 ; 2 (2Q) </p><p>9(9Q)8(8Q)1</p><p> 2Q80.03</p><p>6.039.4572.57</p><p>4.780.96(22)0.96(</p><p>7.06) 91.90 </p><p>31.94</p><p>6.05(1.42)4</p><p> 6.31 (</p><p>3.7)</p><p> 2552-2555 </p><p>71)</p><p>2)3)4)</p><p>5)6)7)</p><p> () </p><p>//</p><p> : 2549</p><p>3.7 2556 33.34 10 </p></li><li><p> 7</p><p>()5</p><p>9Q1</p><p>54</p><p>6 31</p><p>(9Q7)705</p><p> 10 </p><p>96.5</p><p> : </p><p> 1.2Q9Q</p><p>14,381/930/</p><p> 2.</p><p> 3.</p><p>92.3</p><p> 4. </p><p> 5.</p><p> 6. 5 </p><p>6/32</p><p>10</p><p> 2555 (Thailand Public Service Awards) </p><p> (Disability Adjusted Life Years, DALY) </p><p> : </p><p>World Psychiatric Association Spain, Vienna, Portugal,</p><p>CommunicationControlDiseaseofChina</p><p> United Nations Service Public Awards 2013</p></li><li><p>8 </p><p>//</p><p> Key Performance Indicator </p><p> 3 </p><p> ./. 2 </p><p>/ 3 </p><p> CPGMDD GP </p><p> 4 </p><p> 5 </p><p> (2Q+ve) (9Q7)</p><p>(8Q1)</p><p>CPGMDDGP 6 </p><p> 7 </p><p> Offline Online </p><p> ICD10</p></li><li><p> 9</p><p> 2</p><p>2.1 </p><p> 1) </p><p> 2) </p><p> 3) </p><p> 4) </p><p> 5) 6) </p><p> ( 2549; 2551)</p><p> () 2549 </p><p> //</p><p> 2Q </p><p> 9Q 8Q </p><p> . </p><p> 2550 4 </p><p> CVA </p></li><li><p>10 </p><p> 2551-2552 </p><p> // </p><p> 2553-2555 </p><p> // </p><p> 4 Web application </p><p> // </p></li><li><p> 11</p><p> 2Q </p><p> 9Q </p><p> (CPG-</p><p>MDD-GP) </p><p> web application</p><p> ( 1) (Depression) </p><p> 1 </p><p> ( 2)</p><p> 1. </p><p> 2. </p><p> 3. </p><p> 4. / </p><p> 5. </p><p> 6. </p></li><li><p>12 </p><p> 2 </p><p>2.2 </p><p> 1. </p><p> / </p><p> 2. </p><p> () / / </p><p> / </p><p> /</p><p> 3. </p><p> 1. </p><p> 2. </p><p> 3. </p><p> 4. </p></li><li><p> 13</p><p> 5. </p><p> 6. </p><p> 7. </p><p> 8. </p><p> 4. </p><p> ( </p><p>) </p><p> 5. </p><p> 6. </p><p> 1. </p><p> 2. </p><p> 3. 1 </p><p> 4. </p><p> 5. </p><p> 6. </p><p> 7. </p><p>2.3 </p><p> 3 </p><p> 2549 </p></li><li><p>14 </p><p> 3 </p><p>1212121212 </p><p>6. </p><p>1. </p><p>2. </p><p>3. 1 </p><p>4. </p><p>5. </p><p>6. </p><p>7. </p><p> 2.3 </p><p> 3 </p><p> 2549</p><p> ./PCU .. </p><p> 3 </p><p>. ./PCU ./. . </p><p> 9Q</p><p> 9Q</p><p> 2Q DS8</p><p> 8Q</p><p> 9Q</p></li><li><p> 15</p><p> 1. </p><p> 2Q </p><p> 2 </p><p> ( )</p><p> 2. </p><p> ICD-10 DSM-IV </p><p> Gold standard 9Q </p><p> 3 </p><p> 8Q </p><p> ( )</p><p> 3. </p><p> 9Q </p><p> 6 </p></li><li><p>16 </p><p>9Q 6 </p><p> 4. </p><p> 9Q </p><p>1 (Cut of point) 9Q &gt;7 1 </p><p>2.4 </p><p> 2549 </p><p> 3 </p><p> 1 </p><p>2 (2Q)</p><p>- </p><p>.</p><p> .</p><p> ./.</p><p>1) 2Q </p><p>2) </p><p> 2 ( </p><p> 1 2) </p></li><li><p> 17</p><p> (DS8)</p><p>- </p><p>.//./</p><p>.</p><p> ./.</p><p>1) </p><p> = 1 </p><p> = 0 </p><p>2) 1-6 </p><p> 3 </p><p> 3 </p><p>3) 7-8 </p><p> 1 </p><p>1 </p><p>9 (9Q)</p><p>- </p><p>- </p><p> ./.</p><p> 19 = </p><p>8 (8Q)</p><p>- </p><p> ./.</p><p> 0 = </p><p> 1-8 = </p><p> 9-16 = </p><p> &gt;17 = </p></li><li><p>18 </p><p>2.5 </p><p> 2 </p><p> 2 </p><p>1. </p><p>2. ... </p><p>... </p><p>. </p><p>3. </p><p> - () </p><p> - ()</p><p> 1. </p><p>... </p><p>. </p><p>2. </p><p>3. </p><p> () </p><p> ()</p><p>1. </p><p>2. </p><p>3. </p><p>4. </p><p>5. </p><p>6. </p><p>7. </p><p>1. </p><p> . </p><p> 045-352599 045-352598 dowload www.thaidepression.com </p><p> E-mail : info@thaidepression.com</p></li><li><p> 19</p><p> 3 </p><p> 2 </p><p> 1. ()</p><p> 2. () </p><p>3.1 </p><p> 2 </p><p> 1. </p><p> 18 </p><p> 2Q </p></li><li><p>20 </p><p> 2. </p><p> 2Q DS8 </p><p> 1. </p><p> 2. </p><p> 3. </p><p> 4. </p><p> 5. </p><p> 6. </p><p> 7. </p><p> ( 2Q)</p><p> : 2 (2Q)</p><p> : </p><p> : /</p><p> : (.) () ./.</p><p>1. </p></li><li><p> 21</p><p>... </p><p>2. 2Q </p><p>2 </p><p>2 </p><p> 2 ( )</p><p>3. </p><p>4. </p><p> 4.1 2 </p><p> 4.2 2 ( 1 2)</p><p> 9Q </p><p>5. () </p><p> ( </p><p>) </p><p> 9Q </p><p> 9Q 2 3 </p><p>6. </p><p> 9Q ( 9Q 7 </p><p>)</p></li><li><p>22 </p><p> 2Q</p><p> 1. </p><p> 2. </p><p> 3. 2Q </p><p> 9 </p><p> 4. </p><p> 5. 9Q ( 9Q)</p><p> 2 (2Q)</p><p>3</p><p>1</p><p> 2 </p><p> 2 </p><p>: </p><p>2</p><p>()</p><p>2</p><p> 2 </p><p> 2 </p><p>: </p><p>2</p><p>()</p><p> 2 </p><p> 2 ( 1 2) </p><p>9Q</p></li><li><p> 23</p><p>3.2 </p><p> 9Q 8Q </p><p> : 9 (9Q)</p><p> : </p><p> : </p><p> 2Q</p><p> : ./.</p><p>1. </p><p> ...</p><p> 9 </p><p>2. </p><p>3. 9Q </p><p>4. 9Q </p><p>9Q 2 </p></li><li><p>24 </p><p>5. 9 </p><p> 9 </p><p> ( )</p><p>6. </p><p>7. </p><p> 7.1 9Q </p><p> 7.2 </p><p> 2Q </p><p> 9Q </p><p> ... </p><p> 7.3 </p><p> 7.4 7 </p><p> 8Q </p><p>8. &gt;7 </p><p> . . </p><p> 9Q </p></li><li><p> 25</p><p> 9 (9Q)</p><p> 2 </p><p> 2 </p><p> 2 </p><p>2 () </p><p>(</p><p>)</p><p>1-7</p><p>()</p><p>&gt;7()</p><p>()</p><p>1 0 1 2 3</p><p>2 0 1 2 3</p><p>3 </p><p>0 1 2 3</p><p>4</p><p> 0 1 2 3</p><p>5</p><p>/</p><p>0 1 2 3</p><p>6</p><p>0 1 2 3</p><p>7 </p><p>0 1 2 3</p><p>8</p><p>0 1 2 3</p><p>9</p><p>0 1 2 3</p><p>19 </p></li><li><p>26 </p><p> : 8 (8Q)</p><p> : </p><p> : &gt;7 </p><p> 9Q</p><p> : ./.</p><p>1. </p><p> 9Q </p><p> / 8Q </p><p>2. </p><p>/ </p><p>3. </p><p>9Q </p><p>4. </p><p> 0 ( 8)</p></li><li><p> 27</p><p> 8 (8Q)</p><p> ()</p><p>1 </p><p>...</p><p>0 1</p><p>2</p><p>...</p><p>0 2</p><p>3</p><p>1</p><p> ... 0 6</p><p>4</p><p>()...</p><p>()...</p><p>()...() </p><p>0</p><p>8</p><p>4 0 8</p><p>5</p><p> 0 9</p><p>6</p><p>0 4</p><p>7/</p><p>0 10</p><p>8 </p><p> ()</p><p>0 4</p><p>0 </p><p>1-8 </p><p>9-16 </p><p>&gt;17 </p><p> 1-7 1 </p><p> 8</p></li><li><p>28 </p><p>3.3 </p><p> &gt;7 9Q </p><p> 1. </p><p> 5 </p><p> 6</p><p> 2. ()</p><p> 3. ICD-10 </p><p> DSM-IV ( 9Q ) </p><p> 4. </p><p> 5. </p><p> 3 Organic causes of a Depressive symptoms</p><p>Endocrine Disorder of cortisol, thyroxine or parathormone production Eg. Hypopituitarism, </p><p>Hypoglycemia</p><p>Infections Glandular fever, Syphilis, AIDS, Enchephalitis</p><p>Neurological Stroke, Parkinsons disease, Multiple sclerosis, Brain tumors (meningioma), </p><p>Trauma, Cerebral lupus</p><p>Carcinoma Pancreatic carcinoma, Lung carcinoma</p><p>Nutritional Deficiency of Folate, Nicotinamide (pellagra), Vit B12, B1 (Thiamine), and B6</p><p>Other Cerebral ischemia, Myocardial infarction</p></li><li><p> 29</p><p> 4 Pharmacological causes of Depression</p><p>Cardiac and </p><p>antihypertensive drugs</p><p>Bethanidine, Clonidine, Guanethidine, Hydralazine, Methyldopa, </p><p>Propranolol, Reserpine, Digitalis, Prazosin, Procainamide, Veratrum, </p><p>Lidocaine, Oxprenolol, Methoserpidine</p><p>Sedetives and hypnotics Barbiturates, Chloral hydrate, Ethanol, Benzodiazepines, </p><p>Chlormethiazole, Chlorazepate</p><p>Steriods and homones Corticosteriods, Oral contraceptive, Prednisone, Triamcinolone, </p><p>Norethisterone, Danazol</p><p>Stimulants and </p><p>appetite suppressants</p><p>Amphetamine, Fenfluramine, Diethylpropion, Phenmetrazine</p><p>Psychotropic drugs Butyrophenones, Phenothiazines</p><p>Neurological agents Amantadine, Bromocriptine, Levodopa, Tetrabenazine, Baclofen, </p><p>Carbamazepine, Methsuximide, Phenytoin</p><p>Analgesics and </p><p>anti-inflammatory drugs</p><p>Fenoprofen, lbuprofen, Indomethacin, Opiates, Phenacetin, </p><p>Phenylbutazone, Pentazocine, Benzydamine</p><p>Antibacterial and </p><p>antifungal drugs</p><p>Ampicilline, Sulfamethoxazole, Clotrimazole, Cycloserine, Dapsone, </p><p>Ethionamide, Tetracycline, Griseofulvin, Metronidazole, </p><p>Nitrofurantoin, Nalidixic acid, Sulfonamides, Streptomycin, </p><p>Thiocarbanilide</p><p>Antineoplatic drugs C-Asparaginase, Mithramycin, Vincristine, 6-Azauridine, Bleomycin, </p><p>Trimethoprim, Zidovudine</p><p>Miscellaneous drugs Acetazolamine, Choline, Cyproheptadine, Disulfiram, Methysergide, </p><p>Meclizine, Pizotifen</p><p>Anticholinestereses Cimetidine, Diphenoxylate, Lysergide, Mebeverine, Metoclopramide, </p><p>Salbutamol</p><p> Adapted from Cummings JL. Clinical Neuropsychiatry. Orlando, FL: Grune &amp; </p><p>Stratton; 1985 : 187.</p></li><li><p>30 </p></li><li><p> 31</p><p> 4 </p><p> 1. </p><p> 2. </p><p> 3. </p><p> 4. </p><p> 5. </p><p> 6. </p><p>4.1 </p><p> : </p><p> : 2Q</p><p> : () ./.</p><p> 1. </p><p> 2. </p><p> 3. 30-45 3 </p><p> 4. / 2Q </p></li><li><p>32 </p><p>4.2 </p><p> : </p><p> : 2Q</p><p> : ./. 9Q</p><p>1. </p><p>2. </p><p>3. </p><p>4. 30-45 3 </p><p>5. EQ</p><p>6. / 2Q </p><p>4.3 </p><p> : </p><p> : = 7-12 9Q</p><p>1. 8Q</p><p>2. </p><p>3. </p><p>4. 30-45 2-3 </p><p>5. / . . </p><p> . .</p><p>1. </p><p> 9Q &gt;7 8Q</p><p>2. </p><p>3. R/O </p></li><li><p> 33</p><p>4. </p><p> 30-45 3 ( )</p><p>5. </p><p>()</p><p>6. 9Q</p><p>4.4 </p><p> : </p><p> : = 13 - 18 9Q</p><p>1. 8Q</p><p>2. </p><p>3. </p><p>4. 30-45 2-3 </p><p>5. / . . </p><p> . .</p><p>1. </p><p> 9Q &gt;7 8Q</p><p>2. </p><p>3. R/O </p><p>4. </p><p> ()</p><p>5. (Antidepressant) </p><p>6. </p><p> Psychotherapy </p><p> (Antidepressant) </p></li><li><p>34 </p><p>4.5 </p><p> : </p><p> : &gt;19 </p><p> 9Q</p><p>1. 8Q</p><p>2. </p><p>3. </p><p>4. 30-45 2-3 </p><p>5. / . . </p><p> . .</p><p>1. </p><p> 9Q &gt;7 </p><p>8Q</p><p>2. </p><p>3. R/O </p><p>4. </p><p> ()</p><p>5. (Antidepressant) </p><p>6. </p><p>Psychotherapy (Antidepressant) ()</p><p>7. ./. </p><p> 1-2 </p></li><li><p> 35</p><p>4.6 /</p><p> : </p><p> /</p><p> : &gt;7 </p><p> 9Q 1 </p><p> 8Q</p><p> 1. (8Q = 1-8 )</p><p> 1.1 () </p><p> 1.2 </p><p> 2. (8Q = 9-16 ) </p><p> 2.1 </p><p> 2.2 </p><p> 2.3 </p><p> ()</p><p> 2.4 </p><p> 3. (8Q &gt; 17 )</p><p> 3.1 24 </p><p> 3.2 </p><p> 3.3 9Q &gt; 13 </p><p> : </p><p> 8 9 </p><p> 0 ( 8) </p></li><li><p>36 </p><p>4.7 (Antidepressant) </p><p>Logo </p></li><li><p> 37</p><p>Logo </p><p>Logo </p></li><li><p>38 </p><p>Logo </p></li><li><p> 39</p><p> 5</p><p> / </p><p>(</p><p> 2Q)</p><p> 7-12 </p><p> 9Q</p><p> 13-18 </p><p> 9Q</p><p> &gt;19 </p><p>/</p><p> &gt;17 </p><p> 8Q</p><p>. </p><p>(</p><p>)</p><p>..</p><p>./</p><p>.</p><p>.</p><p>..</p><p>./.</p><p>..</p><p> 9Q .. ( </p><p> . PCU </p><p> 9Q )</p><p>1. </p><p> ./.</p><p>2. </p><p>3. </p><p> 9Q</p><p>1. . ( . . )</p><p>2. 9Q </p><p> 8Q 3. </p></li><li><p>40 </p><p> ()</p><p> / </p><p> 9Q</p></li><li><p> 41</p><p> 6 </p><p> (Relapsed) 6 </p><p> (Frank et al. 1991) Major Depression </p><p> Keller (1983) 22</p><p> (Recurrent) </p><p> 6 Naturalistic follow-up study </p><p> 1 37 (Lin et al. 1998)</p><p> 2 25-40 (Keller and Boland 1998)</p><p>1. ( 9Q</p></li><li><p>42 </p></li><li><p> 43</p><p> 7</p><p>7.1 </p><p>4343434343</p><p> 7</p><p> 7.1 </p><p>/</p><p>***</p><p>***</p><p>***</p><p>-</p><p>-</p><p>*</p><p>*</p><p>- </p><p>- .</p><p>- </p><p>-------------</p><p>----</p><p>----</p><p>----</p><p>----</p><p>-</p><p>----------</p><p>-------</p><p>----</p><p>----</p><p>--</p><p>----</p><p>----</p><p>----</p><p>-</p><p>- ---------</p><p>**</p><p>**</p><p>**</p><p>* 2Q, ** 9Q , ***ICD10, DSM IV-TR</p></li><li><p>44 4444444444 </p><p> 7.2 </p><p> (Health Information System : HIS) </p><p>7.2.1 </p><p>Data : Information : Knowledge</p><p>1. (Data) </p><p> (Data) </p><p>- 20,000 </p><p>- 2,000 </p><p>- 150 </p><p>- 9Q 100 </p><p>- 9Q7 80 - 9Q7 F32 80 - 30 </p><p>- 30 </p><p>7.2 </p><p> (Health Information System : HIS) </p><p> 7.2.1 </p><p> 1. (Data) </p><p> (Data) </p><p> 20,000 </p><p> 2,000 </p><p> 150 </p><p> 9Q 100 </p><p> 9Q&gt;7 80 </p><p> 9Q&gt;7 F32 80 </p><p> 30 </p><p> 30 </p></li><li><p> 45</p><p> 2. (Information) </p><p> (Data) 1 </p><p> 10%</p><p> 7.5%</p><p> 80%</p><p> 9Q&gt;7 100%</p><p> 2.5%</p><p> 100%</p><p> 3. (Knowledge) </p><p> (Informa-</p><p>tion) 2 </p><p> 10-20% </p><p> ( </p><p> 7.5%)</p><p> 9Q 50 </p><p> ( </p><p> 9Q 50 )</p><p> 9Q&gt;7 </p><p>7.3 </p><p> 1. </p><p> 2. </p><p> 3. </p><p> 4. </p><p> 5. </p></li><li><p>46 </p><p> 6. </p><p> CVA </p><p> ()</p><p> 1. </p><p> 2. (2Q-ve)</p><p> 3. (2Q+ve)</p><p> 9Q</p><p> 1. 9Q </p><p> 2. (9Q19)</p><p> 8Q</p><p> 1. 8Q </p><p> 2. (8Q=0)</p><p> 3. (8Q=1-8)</p><p> 4. (8Q=9-16)</p><p> 5. (8Q&gt;17)</p><p> 1. </p><p> 2. F32 : Depressive episode</p><p> 3. F33 : Recurrent depressive disorder</p><p> 4. F34. 1 : Dysthymia</p><p> 5. F38 : Other single mood (affective) disorders</p><p> 6. F39 : Unspecified mood (affective) disorder</p></li><li><p> 47</p><p> 1. </p><p> 2. </p><p> 3. </p><p> 4. </p><p> 5. </p><p> 6. </p><p> 7. </p><p> 8. </p><p> 9. 9Q, 8Q</p><p> 10. () . </p><p> ()</p><p> 11. </p><p> 10 </p><p> 1. Acute phase : 9Q &gt;7</p><p> 2. Maintenance : 9Q</p></li><li><p>48 </p><p>7.4 </p><p> 2 </p><p> 1. Depression Offline </p><p> Online </p><p> Online internet </p><p> Depression Offline ()</p><p> Depression Offline (Version)</p><p> 2. Depression Online/Real time </p><p> Internet </p><p> Web site : thaidepression.com</p><p> Depression Online (Version)</p></li><li><p> 49</p><p>7.5 </p><p> 9Q</p><p> 8Q</p></li><li><p>50 </p><p>7.6 </p><p> (KPI) (Process) (Outcome) (Impact) </p><p> KPI 7.6.1-3 </p><p> (Coverage) (Timeliness) </p><p>(Compliance) </p><p> 7.6.1 (Process)</p><p>Process KPI (Numerator) (Denominator) </p><p>100%</p><p>9Q</p><p>9Q</p><p>100%</p><p>9Q&gt;7</p><p>9Q&gt;7</p><p>100%</p></li><li><p> 51</p><p>Process KPI (Numerator) (Denominator) </p><p>8Q</p><p>9Q&gt;7</p><p>100%</p><p>(9Q08Q)</p><p>8Q&gt;0</p><p>100%</p><p> 7.6.2 (Outcome)</p><p>Outcome KPI (Numerator) (Denominator) </p><p>-</p><p>&gt;5%</p><p>(</p><p>100%</p><p>9Q7Majordepressiveepisode</p><p>0%</p></li><li><p>52 </p><p> 7.6.3 (Impact)</p><p>Impact KPI (Numerator) (Denominator) </p><p>0%</p><p>Incidencerate </p><p>Prevalencerate </p><p>7.7 </p><p> 2 (2Q) </p><p>9 (9Q) 8 (8Q) </p><p> . </p><p> . </p><p> . </p></li><li><p> 53</p><p> . </p><p> . 1 </p><p> 2 </p><p> . </p><p>www.thaidepression.com,</p><p> E-mail : info@thaidepression.com</p></li><li><p>56 </p><p>1. </p><p> Sad, Blue, Upset, Disappointment, Downness, Despair </p><p> ( </p><p>, 2549) </p></li><li><p> 57</p><p>2. </p><p> Depressive disorders </p><p> 2 2 ICD (International </p><p>Classification of Diseases and health-related problems) DSM </p><p>(Diagnostic and Statistical Manual of Mental disorders) (American </p><p>Psychiatric Association 2000) </p><p> 1. </p><p> 2. </p><p> 3. </p><p> ( 2-3 . )</p><p> 4. </p><p> 1-2 </p><p> 5. </p><p> 6. </p><p> 7. ( </p><p> )</p><p> 8. </p><p> 9. </p><p> 5 2 ( 1) </p><p> ( 2) </p><p>3. </p></li><li><p>58 </p><p> 2.8 </p><p>31-42% </p><p> (First onset) </p><p> (Relapse) </p><p> 2-3 </p><p>4. </p><p> 2.7 15 </p><p> 1,311,797 (Major Depressive Disorder) </p><p> 181,809 (Dysthymia)</p><p>5. </p><p> () </p><p> ( ) </p></li><li><p> 59</p><p> 30-45 () </p><p> 3 </p><p> 2-3 </p><p> 1-2 8 </p><p> 6 1 </p></li><li><p>60 </p><p>6. </p><p> 1. </p><p> 2. </p><p> 3. </p><p> : </p></li><li><p>62 </p><p>1. </p><p> .. 2551 15 Major depressive disorder 2.4% </p><p> Dysthymia 0.3% </p><p> ( , 2551)</p><p> (Congestive heart failure) (Well, 1989) </p><p>4 2 .. 2020 (Murrey, 1996)</p><p> 50%-70% </p><p> (Coyne, 1995 ; Schulberg, 1997)</p><p>2. </p><p> 20-25 (Median age of onset) (Andrade et al, </p><p>2003: Burke et al, 1991) </p><p> (Long-term naturalistic studies) </p><p> (Life long illness) (Keller, 1992 : Mulle, 1996 </p><p>: Keller, 1998 : Brodaty, 2001) </p><p> 20 (No remission) </p><p>(Thornicroft, 1993) 4 (Judd, 1997)</p><p> (First episode) </p><p> (Kessler, 1997) </p></li><li><p> 63</p><p> Melatin et al. (2004) (Naturalistic cohort study) </p><p> Major depressive disorder </p><p> 1.5 (95%CI 1.3-1.7) </p><p> Spijker et al. (2002) Cohort study Major Depressive Disorder </p><p> 273 2 Survival-analysis </p><p> Median time of duration 3 (95%CI 2.2-3.8)</p><p> 6 </p><p> (Relapse) (Frank et al. 1991) Major Depression </p><p> Keller (1983) 22</p><p> (Recurrent) </p><p> 6 Naturalistic follow-up study </p><p> 1 37 (Lin et al, 1998)</p><p> 2 25-40 (Keller and Boland, 1998)</p><p>3. </p><p> Systematic review The US task force </p><p> (Pignone, 2002)</p><p> (USPSTF, 2002)</p><p> 2 Over the past 2 weeks, have you felt down, depressed, </p><p>hopeless? and Over the past 2 weeks, have you felt little interest or pleasure in doing things? </p><p> (USPSTF, 2002. ; Whooley, 1997)</p><p> 2 (2Q) </p><p> (Sensitivity) </p><p> 97% (Specificity) 44% ( , </p><p>2550) </p><p> 9 (9Q) </p><p> 93% (Likelihood ratio positive) 11.4 (, in-press) </p></li><li><p>64 </p><p>(USPSTF, 2002) ICD10 DSM-IV</p><p>4. </p><p> (Jorm, 2002) </p><p> Circadian rhythm </p><p>Circadian rhythm </p><p> (Seasonal </p><p>affective disorder) </p><p>(Meta-analysis) </p><p> (Lee, 1999) </p><p> (Kripke, 1998)</p><p>() </p><p> (</p><p>) </p><p> (Field, 1996 and 1998)</p><p> (Komori, 1995) </p></li><li><p> 65</p><p>(Jogging, Running, </p><p>Walking, </p><p>Progressive </p><p>resistance </p><p>training, </p><p>Bicycling)</p><p> (Babyak, 2000 </p><p>: Singh, 2001)</p><p> (Davidson, 1995)</p><p> (Christensen, 1990) </p><p>5. </p><p> Tricyclic antidepressants </p><p>(Amitriptyline, N

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