Vergouwen A C M, Burger H, Verheij T J M, Koerselman G F
Sint Lucas Andreas Ziekenhuisin Amsterdam.
Tijdschr Psychiatr. 2007;49(8):559-67.
The results of treatment for depression are frequently disappointing. The main reasons for this are inadequate treatment and non-compliance.
This article attempts to deal with the question of how patient compliance and the results of treatment for depression can be improved.
We performed a critical analysis of the literature. We searched Medline (1966- January 2002), psycinfo (1984-January 2002), Embase (1980-January 20002) and the Cochrane Controlled Trials Register (1966-Janaury 2002) for reports of randomised controlled trials. In our search we used the terms 'patient compliance', 'adherence', patient dropout', 'depression', 'depressive disorder', and 'affective disorder'. On the basis of the results of our search we compared two interventions that could be applied in Dutch practices. results We found 11 articles, all relating to treatment in primary care settings. Usual care proved to be inadequate. The quality of the usual care currently provided can be improved by extra interventions. So far there are no indications that complex interventions benefit the patient more than simple interventions, such as regular follow-up procedures. Therefore, for the time being, simple interventions are to be preferred.
Treatment for depression can be improved by means of relatively simple interventions.
抑郁症的治疗结果常常令人失望。主要原因是治疗不充分和患者不依从。
本文试图探讨如何提高患者的依从性以及改善抑郁症的治疗效果。
我们对文献进行了批判性分析。我们检索了Medline（1966年至2002年1月）、psycinfo（1984年至2002年1月）、Embase（1980年至2002年1月）以及Cochrane对照试验注册库（1966年至2002年1月），以查找随机对照试验的报告。在检索中我们使用了“患者依从性”“坚持治疗”“患者退出治疗”“抑郁症”“抑郁障碍”和“情感障碍”等术语。根据检索结果，我们比较了两种可应用于荷兰医疗实践的干预措施。结果我们找到11篇文章，均与初级保健机构中的治疗有关。常规治疗被证明是不充分的。通过额外的干预措施可以提高当前提供的常规治疗的质量。到目前为止，没有迹象表明复杂干预措施比简单干预措施（如定期随访程序）对患者更有益。因此，目前应优先选择简单干预措施。
通过相对简单的干预措施可以改善抑郁症的治疗。
