Weich Scott, Morgan Louise, King Michael, Nazareth Irwin
Health Sciences Research Institute, Warwick Medical School, University of Warwick, Coventry, UK.
Psychol Med. 2007 Sep;37(9):1239-48. doi: 10.1017/S0033291707000931. Epub 2007 Jun 11.
Undertreatment of depression in primary care is common. Efforts to address this tend to overlook the role of patient attitudes. Our aim was to validate and describe responses to a questionnaire about attitudes to depression and its treatment in a sample with experience of moderate and severe depressive episodes.
Cross-sectional survey of 866 individuals with a confirmed history of an ICD-10 depressive episode in the 12 months preceding interview, recruited from 7271 consecutive general practitioner (GP) attendees in 36 general practices in England and Wales. Attitudes to and beliefs about depression were assessed using a 19-item self-report questionnaire.
Factor analysis resulted in a three-factor solution: factor 1, depression as a disabling, permanent state; factor 2, depression as a medical condition responsive to support; and factor 3, antidepressants are addictive and ineffective. Participants who received and adhered to antidepressant medication and disclosed their depression to family and friends had significantly lower scores on factors 1 and 3 but higher scores on factor 2.
People with moderate or severe depressive episodes have subtle and divergent views about this condition, its outcome, and appropriate help. Such beliefs should be considered in primary care as they may significantly impact on help seeking and adherence to treatment.
初级医疗中抑郁症治疗不足的情况很常见。解决这一问题的努力往往忽视了患者态度的作用。我们的目的是验证并描述一份关于抑郁症及其治疗态度的问卷在有中度和重度抑郁发作经历的样本中的应答情况。
对866名在访谈前12个月有确诊的ICD - 10抑郁发作史的个体进行横断面调查，这些个体从英格兰和威尔士36家全科诊所的7271名连续就诊的全科医生（GP）患者中招募。使用一份包含19个条目的自填问卷评估对抑郁症的态度和信念。
因子分析得出一个三因子解决方案：因子1，抑郁症是一种致残的、永久性的状态；因子2，抑郁症是一种对支持有反应的医学状况；因子3，抗抑郁药会上瘾且无效。接受并坚持服用抗抑郁药物且向家人和朋友透露自己抑郁情况的参与者在因子1和因子3上的得分显著较低，但在因子2上的得分较高。
有中度或重度抑郁发作的人对这种疾病、其结果以及适当的帮助有微妙且不同的看法。在初级医疗中应考虑这些信念，因为它们可能会对寻求帮助和坚持治疗产生重大影响。
