Fann Jesse R, Jones Audrey L, Dikmen Sureyya S, Temkin Nancy R, Esselman Peter C, Bombardier Charles H
Departments of Psychiatry & Behavioral Sciences, School of Public Health and Community Medicine, University of Washington, Seattle, USA.
J Head Trauma Rehabil. 2009 Jul-Aug;24(4):272-8. doi: 10.1097/HTR.0b013e3181a66342.
To determine preferences for depression treatment modalities and settings among persons with traumatic brain injury (TBI).
Telephone survey. Depression status was determined using the Patient Health Questionnaire-9.
Harborview Medical Center, Seattle, Washington, the level I trauma center serving Washington, Idaho, Montana, and Alaska.
One hundred forty-five adults, English-speaking consecutive patients admitted with complicated mild to severe TBI.
Telephone survey within 12 months post-TBI ascertaining preferences for depression treatment modalities and settings.
More patients favored physical exercise or counseling as a depression treatment than other treatment modalities. Group therapy was the least favored modality. Patients favored speaking with a clinician in the clinic or over the telephone and were less likely to communicate with a clinician over the Internet. Subjects with probable major depression or a history of antidepressant use or outpatient mental health treatment were more likely to express a preference for antidepressants for treatment of depression.
This study underscores the importance of understanding patient preferences and providing patient education in selecting a treatment for depression after TBI. Future studies should examine psychotherapy and alternative treatment modalities and delivery models for the management of depression in this vulnerable population.
确定创伤性脑损伤（TBI）患者对抑郁症治疗方式和治疗环境的偏好。
电话调查。使用患者健康问卷-9来确定抑郁状态。
华盛顿州西雅图市的海港景医疗中心，这是为华盛顿州、爱达荷州、蒙大拿州和阿拉斯加州服务的一级创伤中心。
145名成年英语患者，为连续收治的伴有复杂轻至重度TBI的患者。
在TBI后12个月内进行电话调查，以确定对抑郁症治疗方式和治疗环境的偏好。
与其他治疗方式相比，更多患者倾向于将体育锻炼或咨询作为抑郁症治疗方法。团体治疗是最不受青睐的方式。患者倾向于在诊所或通过电话与临床医生交流，而通过互联网与临床医生交流的可能性较小。可能患有重度抑郁症或有抗抑郁药使用史或门诊心理健康治疗史的受试者更有可能表示倾向于使用抗抑郁药治疗抑郁症。
本研究强调了了解患者偏好并在TBI后选择抑郁症治疗方法时提供患者教育的重要性。未来的研究应探讨心理治疗以及针对这一弱势群体抑郁症管理的替代治疗方式和提供模式。
