Agarwal Parul, Pan Xiaoyun, Sambamoorthi Usha
BMC Psychiatry. 2013 Apr 22;13:121. doi: 10.1186/1471-244X-13-121.
Arthritis and depression often co-occur; however, studies that describe patterns of depression treatment among individuals with arthritis are scant. The purpose of the study was to examine depression treatment patterns among individuals with osteoarthritis (OA) by predisposing, enabling, need factors, personal health practices and external health environment.
Retrospective cross-sectional design was used. Data were obtained from 2008 and 2010 Medical Expenditure Panel Survey (MEPS). The sample consisted of 647adults aged over 21 years with depression and OA. Depression treatment was categorized as: 1) No treatment;2) antidepressant use only and 3) both antidepressants and psychotherapy (combination therapy). Chi- square tests and multinomial logistic regressions were used to describe patterns of depression treatment. All analysis was performed using Statistical Analysis Software (SAS) version 9.3.
Overall, 13.0% of the study sample reported no depression treatment, 67.8% used antidepressants only and 19.2% used combination therapy. Among individuals with OA significant subgroup differences in depression treatment were observed. For example, African Americans were less likely to report depression treatment compared to whites [antidepressants: AOR=0.33, 95% CI=0.21,0.51; combination therapy: AOR=0.39, 95% CI=0.23, 0.65]. Elderly adults were more likely to receive antidepressants and less likely to receive psychotherapy as compared to younger adults [AOR=0.53, 95% CI= 0.28,0.98]. Adults with anxiety were more likely to report depression treatment compared to those without anxiety [antidepressants: AOR=1.53, 95% CI=1.06, 2.22; combination therapy: AOR=3.52, 95% CI=2.40, 5.15].
Future research needs to examine the reason for low rates of combination therapy as well as subgroup differences in combination therapy among individuals with OA.
关节炎与抑郁症常同时出现；然而，描述关节炎患者抑郁症治疗模式的研究却很少。本研究的目的是通过易患因素、促成因素、需求因素、个人健康行为和外部健康环境来研究骨关节炎（OA）患者的抑郁症治疗模式。
采用回顾性横断面设计。数据来自2008年和2010年医疗支出面板调查（MEPS）。样本包括647名年龄在21岁以上患有抑郁症和骨关节炎的成年人。抑郁症治疗分为：1）未治疗；2）仅使用抗抑郁药；3）同时使用抗抑郁药和心理治疗（联合治疗）。采用卡方检验和多项逻辑回归来描述抑郁症治疗模式。所有分析均使用统计分析软件（SAS）9.3版进行。
总体而言，13.0%的研究样本报告未进行抑郁症治疗，67.8%仅使用抗抑郁药，19.2%使用联合治疗。在骨关节炎患者中，观察到抑郁症治疗存在显著的亚组差异。例如，与白人相比，非裔美国人报告接受抑郁症治疗的可能性较小[抗抑郁药：比值比（AOR）=0.33，95%置信区间（CI）=0.21，0.51；联合治疗：AOR=0.39，95%CI=0.23，0.65]。与年轻人相比，老年人更有可能接受抗抑郁药治疗，而接受心理治疗的可能性较小[AOR=0.53，95%CI=0.28，0.98]。与没有焦虑症的成年人相比，患有焦虑症的成年人报告接受抑郁症治疗的可能性更大[抗抑郁药：AOR=1.53，95%CI=1.06，2.22；联合治疗：AOR=3.52，95%CI=2.40，5.15]。
未来的研究需要探讨联合治疗率低的原因以及骨关节炎患者联合治疗中的亚组差异。
