Department of Social and Behavioral Health, Virginia Commonwealth University School of Medicine, PO Box 980212, Richmond, VA 23298, USA.
Gen Hosp Psychiatry. 2011 Jan-Feb;33(1):66-74. doi: 10.1016/j.genhosppsych.2010.12.002. Epub 2011 Jan 20.
To explore the relationship between treatment setting characteristics and diagnostic attributions of depression among community-dwelling African Americans.
Data come from the National Survey of American Life, a nationally representative sample of African Americans and Caribbean Blacks. Major Depression (MD) was assessed using the Composite International Diagnostic Inventory. Participants were categorized into four diagnostic groups: never MD, MD never attributed to physical health problems (i.e., affective depression), MD sometimes attributed to physical health problems (i.e., complicated depression), and MD always attributed to physical health problems (i.e., physical depression). Multinomial regression was used for assessment.
Among 441 participants, 66.4% were classified as affective depression, 17.8% as complicated depression and 15.8% as physical depression. Seeking treatment from a mental health professional was associated with increased likelihood of being in the complicated depression group [adjusted odds ratio (AOR): 5.52; 95% confidence interval (CI): 2.28-13.36]. Seeking treatment from a family doctor was associated with physical depression (AOR: 2.93; 95% CI: 1.18-7.26). Seeking care from three or more different health care providers was associated with complicated depression (AOR: 1.99; 95% CI: 1.17-3.40).
Results suggest that encounters with health care providers influence the diagnostic attribution of depression in a systematic manner.
探讨治疗环境特征与社区居住的非裔美国人抑郁诊断归因之间的关系。
数据来自全国非裔美国人生活调查，这是一个具有全国代表性的非裔美国人和加勒比黑人样本。使用复合国际诊断清单评估主要抑郁症（MD）。将参与者分为四个诊断组：从未患有 MD、MD 从不归因于身体健康问题（即情感性抑郁症）、MD 有时归因于身体健康问题（即复杂抑郁症）和 MD 始终归因于身体健康问题（即身体性抑郁症）。使用多项回归进行评估。
在 441 名参与者中，66.4%被归类为情感性抑郁症，17.8%为复杂抑郁症，15.8%为身体性抑郁症。向心理健康专业人员寻求治疗与更有可能被归类为复杂抑郁症组相关（调整后的优势比（AOR）：5.52；95%置信区间（CI）：2.28-13.36）。向家庭医生寻求治疗与身体性抑郁症相关（AOR：2.93；95% CI：1.18-7.26）。向三个或更多不同医疗保健提供者寻求治疗与复杂抑郁症相关（AOR：1.99；95% CI：1.17-3.40）。
结果表明，与医疗保健提供者的接触以系统的方式影响抑郁的诊断归因。
