Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA.
Gen Hosp Psychiatry. 2012 May-Jun;34(3):213-20. doi: 10.1016/j.genhosppsych.2012.01.002. Epub 2012 Feb 6.
There is no published evidence on the adequacy of depression care among college students and how this varies by subpopulations and provider types. We estimated the prevalence of minimally adequate treatment among students with significant past-year depressive symptoms.
Data were collected via a confidential online survey of a random sample of 8488 students from 15 colleges and universities in the 2009 Healthy Minds Study. Depressive symptoms were assessed by the Patient Health Questionnaire-2, adapted to a past-year time frame. Students with probable depression were coded as having received minimally adequate depression care based on the criteria from Wang and colleagues (2005).
Minimally adequate treatment was received by only 22% of depressed students. The likelihood of minimally adequate treatment was similarly low for both psychiatric medication and psychotherapy. Minimally adequate care was lower for students prescribed medication by a primary care provider as compared to a psychiatrist (P<.01). Racial/ethnic minority students were less likely to receive depression care (P<.01).
Adequacy of depression care is a significant problem in the college population. Solutions will likely require greater availability of psychiatry care, better coordination between specialty and primary care using collaborative care models, and increased efforts to retain students in psychotherapy.
目前尚无关于大学生抑郁治疗充分性的相关研究，也不清楚不同亚人群和治疗提供方之间的差异。本研究旨在评估过去一年有抑郁症状的大学生中，接受充分治疗的比例。
通过 2009 年“健康思维研究”对 15 所大学中 8488 名学生进行的一项在线匿名调查收集数据。采用患者健康问卷-2 评估抑郁症状，适应过去一年的时间框架。Wang 等人（2005）制定的标准将有抑郁倾向的学生编码为接受了充分的抑郁治疗。
仅有 22%的抑郁学生接受了充分治疗。接受精神科药物治疗和心理治疗的学生接受充分治疗的可能性也同样较低。与精神科医生相比，初级保健医生开出的药物治疗（P<.01）更不可能充分治疗。少数民族学生接受抑郁治疗的可能性更低（P<.01）。
充分的抑郁治疗是大学生群体中的一个严重问题。解决这一问题可能需要更多的精神病学治疗资源，更好地协调专科治疗和初级保健治疗，通过合作治疗模式，以及更努力地让学生坚持心理治疗。
