Prins Marijn A, Verhaak Peter F M, Bensing Jozien M, van der Meer Klaas
Netherlands Institute for Health Services Research, Utrecht, The Netherlands.
Clin Psychol Rev. 2008 Jul;28(6):1038-58. doi: 10.1016/j.cpr.2008.02.009. Epub 2008 Mar 7.
Patients' illness representations and beliefs about treatment for depression and anxiety, as well as their perceived needs, are important for treatment. A systematic review was conducted of 71 studies describing the beliefs or perceived needs of patients and non-patients. Patients give multi-dimensional explanations for depression and see both psychological and medication treatment as helpful. People who suffer from depression have more positive beliefs about biological etiology and medication treatment than healthy people, or those with less severe depressive symptoms. Anxiety patients view psychological interventions as their best treatment option. Between 49% and 84% of the patients with depression or anxiety perceive a need for treatment, mostly for counseling and medication. All patients prefer psychological treatment forms to medication. A majority of patients view antidepressants as addictive and many perceive stigma and see practical and economic barriers to care. The most vulnerable groups in terms of seeking and receiving mental health care for depression and anxiety seem to be minority groups, as well as younger and older patients. More research is required into the specific needs of anxiety and depression patients. Open communication between patient and provider could lead to valuable improvements in treatment.
患者对抑郁症和焦虑症的疾病认知、治疗观念以及他们所感知到的需求,对治疗而言至关重要。对71项描述患者和非患者观念或感知需求的研究进行了系统综述。患者对抑郁症给出多维度解释,并认为心理治疗和药物治疗均有帮助。与健康人群或抑郁症状较轻者相比,抑郁症患者对生物学病因和药物治疗持有更积极的观念。焦虑症患者将心理干预视为最佳治疗选择。49%至84%的抑郁症或焦虑症患者认为需要治疗,主要是为了咨询和药物治疗。所有患者都更倾向于心理治疗形式而非药物治疗。大多数患者认为抗抑郁药会上瘾,许多人还感受到污名化,并认为存在实际和经济方面的就医障碍。在寻求和接受抑郁症及焦虑症心理健康护理方面,最脆弱的群体似乎是少数群体以及年轻和老年患者。需要对焦虑症和抑郁症患者的具体需求开展更多研究。患者与医疗服务提供者之间的开放沟通可能会给治疗带来有价值的改善。