College of Physicians and Surgeons, Columbia University, New York, USA.
Clin Psychol Psychother. 2012 Mar-Apr;19(2):106-12. doi: 10.1002/cpp.1775. Epub 2012 Feb 22.
Depression is highly prevalent and debilitating among medically ill patients. As high as one third of the primary practise patients screen positive for depression symptoms and over half of the patients diagnosed with major depressive disorder are treated in primary care. However, current primary care service arrangements do not efficiently triage patients who screen positive for depression into appropriate treatments that reflect their individual needs and preferences. In this paper, we describe a tool that aims to fill the gap between screening the patients for depression and triaging them to appropriate care. This is a three-session adaptation of interpersonal psychotherapy: ipt; evaluation, support, triage (IPT-EST). We first outline IPT-EST procedures that aim to provide structure and content to primary care practitioners who identify patients with positive depression symptoms, thus assisting the practitioners to explore the patients' psychosocial triggers of depression, give basic strategies to manage these interpersonal stressors and provide decisions tools about triaging patients with severe/persistent depression into appropriate treatment.
在患有疾病的患者中,抑郁症的发病率很高,且病情严重。高达三分之一的初级保健患者筛查出有抑郁症状,超过一半的被诊断患有重度抑郁症的患者在初级保健中接受治疗。然而,目前的初级保健服务安排并不能有效地将筛查出有抑郁症状的患者分诊到反映他们个人需求和偏好的适当治疗中。在本文中,我们描述了一种旨在填补筛查患者抑郁症状和将其分诊到适当护理之间差距的工具。这是人际心理治疗的三个疗程改编版:IPT;评估、支持、分诊(IPT-EST)。我们首先概述了 IPT-EST 程序,旨在为识别出有阳性抑郁症状的患者的初级保健从业者提供结构和内容,从而帮助从业者探讨患者抑郁的心理社会触发因素,提供基本策略来管理这些人际压力源,并提供决策工具,将患有严重/持续抑郁的患者分诊到适当的治疗中。