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从抑郁症中康复的关键是什么?医生与患者之间的不一致(1)。

What is important in being cured from depression? Discordance between physicians and patients (1).

作者信息

Demyttenaere Koen, Donneau Anne-Françoise, Albert Adelin, Ansseau Marc, Constant Eric, van Heeringen Kees

机构信息

University Psychiatric Centre, University of Leuven, Campus Gasthuisberg, Leuven, Belgium.

Department of Medical Informatics and Biostatistics, University of Liège, CHU, Sart Tilman, Liège, Belgium.

出版信息

J Affect Disord. 2015 Mar 15;174:390-6. doi: 10.1016/j.jad.2014.12.004. Epub 2014 Dec 10.

Abstract

AIMS

The comparison of what physicians and patients consider important in being cured from depression.

METHODS

426 outpatients (in primary care and in psychiatric care) with a clinical diagnosis of major depression were included: at the start of antidepressant treatment, the importance of a range of items for being cured from depression (depressive, anxious and somatic symptoms, positive affect, functional impairment, quality of life) was assessed in physicians and patients separately and a ranking was made; after 3 months of treatment, the importance of these items for being cured from depression was re-assessed in the patients.

RESULTS

The items ranked top 10 by physicians mainly contain depressive symptoms while those ranked top 10 by patients mainly contain positive affect items and this attention to positive affect even increases at 3 months follow-up and is higher in patients with recurrent depression than in patients with a first episode of depression. Somatic symptoms consistently get the lowest ranking, as well in physicians as in patients.

CONCLUSIONS

Physicians differ significantly from patients in what they consider important for 'being cured from depression': physicians mainly focus on alleviation of depressive symptoms while patients mainly focus on the restoration of positive affect.

摘要

目的

比较医生和患者对于抑郁症治愈所认为的重要因素。

方法

纳入426例临床诊断为重度抑郁症的门诊患者(包括初级保健和精神科护理患者):在抗抑郁治疗开始时,分别评估医生和患者对一系列抑郁症治愈相关项目(抑郁、焦虑和躯体症状、积极情绪、功能损害、生活质量)的重要性并进行排序;治疗3个月后,再次评估患者对这些项目对于抑郁症治愈的重要性。

结果

医生排名前十的项目主要包含抑郁症状,而患者排名前十的项目主要包含积极情绪项目,并且这种对积极情绪的关注在3个月随访时甚至增加,且复发性抑郁症患者比首次发作抑郁症患者更高。躯体症状在医生和患者中始终排名最低。

结论

医生和患者对于“抑郁症治愈”所认为的重要因素存在显著差异:医生主要关注抑郁症状的缓解,而患者主要关注积极情绪的恢复。

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