McGlinchey Joseph B, Zimmerman Mark, A Posternak Michael, Friedman Michael, Attiullah Naureen, Boerescu Daniela
Department of Psychiatry and Human Behavior, Brown University School of Medicine, Rhode Island Hospital, Providence, RI, USA.
J Affect Disord. 2006 Oct;95(1-3):79-84. doi: 10.1016/j.jad.2006.04.021. Epub 2006 Jun 6.
Current standards for treatment outcome from major depression assess remission solely from the vantage point of symptom resolution. Recent evidence, however, suggests that depressed patients consider factors beyond symptom resolution as important for defining remission. The goal of this study was to examine the influence of three predictors on patients' views of factors important for achieving remission: gender, age and current depressed state (i.e., remitted or depressed).
Five hundred and sixty-two depressed psychiatric outpatients completed a survey assessing the importance of 16 remission factors. Depressed state was assessed by the Standardized Clinical Outcome Rating scale for Depression (SCOR-D), a clinician rated scale that is based on the number of DSM-IV criteria for a major depressive episode and level of psychosocial impairment present during the past week.
Relative to male patients, females showed a greater likelihood for rating remission factors related to emotional stabilization (e.g., achieving emotional control, being able to cope with normal stress) as very important. Relative to younger cohorts, the oldest depressed patients endorsed a greater number of remission factors as very important and emphasized positive mental health states (e.g., feeling satisfied, having a general sense of well-being) more. There were no significant differences between remitted and depressed patients in rating the remission factors' importance.
Perspectives on remission may be differentially perceived by women versus men and by older versus younger depressed patients.
The study was conducted in a single outpatient clinical practice.
目前重度抑郁症的治疗结果标准仅从症状缓解的角度评估缓解情况。然而,最近的证据表明,抑郁症患者认为除症状缓解之外的因素对于定义缓解也很重要。本研究的目的是检验三个预测因素对患者关于实现缓解的重要因素观点的影响:性别、年龄和当前抑郁状态(即缓解或抑郁)。
562名抑郁的精神科门诊患者完成了一项调查,评估16个缓解因素的重要性。抑郁状态通过抑郁标准化临床结局评定量表(SCOR-D)进行评估,这是一种由临床医生评定的量表,基于过去一周内存在的重度抑郁发作的DSM-IV标准数量和社会心理损害程度。
相对于男性患者,女性更有可能将与情绪稳定相关的缓解因素(例如,实现情绪控制、能够应对正常压力)评定为非常重要。相对于年轻人群体,年龄最大的抑郁患者认可更多的缓解因素为非常重要,并更加强调积极的心理健康状态(例如,感到满足、有总体幸福感)。缓解患者和抑郁患者在评定缓解因素的重要性方面没有显著差异。
女性与男性之间以及年龄较大与年龄较小的抑郁患者之间对缓解的看法可能存在差异。
该研究在单一门诊临床实践中进行。