van Grieken Rosa A, Beune Erik J A J, Kirkenier Anneloes C E, Koeter Maarten W J, van Zwieten Myra C B, Schene Aart H
Department of Psychiatry, Program for Mood Disorders, Academic Medical Center, University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands.
Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
J Affect Disord. 2014;167:153-9. doi: 10.1016/j.jad.2014.05.065. Epub 2014 Jun 6.
More than 50% of all major depressive disorder (MDD) patients experience insufficient improvement from the available treatment options. There is emerging evidence that patients׳ beliefs and experiences about MDD treatment influence treatment outcomes. The aim was to explore patients׳ perspectives on impeding characteristics of professional treatment for the recovery of MDD.
In-depth interviews in a purposive sample with 27 recovered MDD patients who had received professional treatment. Data were qualitatively analyzed using constant comparison.
Participants׳ accounts yielded four major impeding themes: lack of clarity and consensus about the nature of the participants׳ MDD and the content of their treatment; precarious relationship with the clinician; unavailability of mental health care; and insufficient involvement of significant others.
The external generalizability may be limited due to missed other subgroups within depression.
This study identified a comprehensive overview of impeding characteristics in MDD treatment from patients׳ perspectives. This may help clinicians to understand how patients experience MDD treatment, and to incorporate patients׳ perspectives about treatment into their joint decision-making. This can lead towards increased treatment adherence, motivation and finally success.
超过50%的重度抑郁症(MDD)患者在现有治疗方案下改善不充分。越来越多的证据表明,患者对MDD治疗的信念和经历会影响治疗结果。本研究旨在探讨患者对阻碍MDD康复的专业治疗特征的看法。
对27名接受过专业治疗且已康复的MDD患者进行了有目的抽样的深入访谈。采用持续比较法对数据进行定性分析。
参与者的叙述产生了四个主要阻碍主题:对参与者MDD的性质及其治疗内容缺乏清晰性和共识;与临床医生的关系不稳定;无法获得心理健康护理;以及重要他人的参与不足。
由于遗漏了抑郁症中的其他亚组,外部普遍性可能有限。
本研究从患者角度全面概述了MDD治疗中的阻碍特征。这可能有助于临床医生了解患者如何体验MDD治疗,并将患者对治疗的看法纳入他们的共同决策中。这可以提高治疗依从性、积极性,并最终取得成功。