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门诊心身医学实践中与抑郁治疗反应相关的因素:一项探索性回顾性研究。

Factors associated with depression treatment-response in an outpatient psychosomatic medicine practice: an exploratory retrospective study.

机构信息

Mayo Clinic, Rochester, MN 55905, USA.

出版信息

Psychosomatics. 2012 Jul-Aug;53(4):387-91. doi: 10.1016/j.psym.2011.04.004. Epub 2012 Feb 3.

Abstract

BACKGROUND AND OBJECTIVE

The author explored depression management outcomes in an outpatient psychosomatic medicine (PM) practice to identify factors associated with treatment response.

METHODS

Medical records of 251 patients seen in the Mayo Clinic Rochester outpatient PM clinic who had patient health questionnaire-9 (PHQ-9) scores at the time of initial consultation and after consultation were reviewed. Comparisons of differences in pre- and post-consultation PHQ-9 scores were evaluated to identify patients with treatment response (score decreased > 50%).

RESULTS

A total of 112 (44.6%) patients had initial PHQ-9 scores ≥ 5. Univariate comparisons revealed higher likelihood of response (25.9%) with lower average number of past antidepressant and antipsychotic trials, and reported good friend and family social support. After controlling for average number of medication trials, reported good friend support remained predictive of response (OR 3.4225, χ2 4.6743, P = 0.31); there was a trend for reported good family support to remain predictive (OR 2.7956; χ2 2.5933, P= 0.097).

CONCLUSION

Though exploratory and underpowered to adequately assess all potential contributors, retrospective examination of factors associated with depression treatment-response in this outpatient PM practice emphasizes the relevance of perception of social support as markers of prognosis and outcome.

摘要

背景与目的

作者在一家门诊身心医学(PM)诊所探索了抑郁管理的结果,以确定与治疗反应相关的因素。

方法

回顾了在梅奥诊所罗切斯特门诊 PM 诊所就诊的 251 名患者的病历,这些患者在初次就诊和就诊时均有患者健康问卷-9(PHQ-9)评分。评估了就诊前和就诊后 PHQ-9 评分的差异比较,以确定治疗反应(评分下降> 50%)的患者。

结果

共有 112 名(44.6%)患者初始 PHQ-9 评分≥5。单变量比较显示,过去抗抑郁药和抗精神病药试验次数较少,以及报告良好的朋友和家庭社会支持,与更高的反应可能性(25.9%)相关。在控制平均用药试验次数后,报告良好的朋友支持仍然与反应相关(OR 3.4225,χ2 4.6743,P = 0.31);报告良好的家庭支持也有预测作用的趋势(OR 2.7956;χ2 2.5933,P = 0.097)。

结论

尽管这项回顾性研究是探索性的,并且没有足够的能力来充分评估所有潜在的贡献因素,但对这家门诊 PM 实践中与抑郁治疗反应相关的因素进行的回顾性检查强调了社会支持的感知作为预后和结果的标志物的相关性。

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