Substance Abuse & Mental Health Services Administration, Center for Behavioral Health Statistics and Quality, Rockville, MD.
Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Psychiatry, Johns Hopkins University, Baltimore, MD.
Gen Hosp Psychiatry. 2015 Jul-Aug;37(4):340-6. doi: 10.1016/j.genhosppsych.2015.04.006. Epub 2015 Apr 13.
This study examined the differences in the level of perceived helpfulness of treatments received for a major depressive episode (MDE) from a general medical provider only, a specialty mental health provider only or both.
This study examined a sample of 8900 respondents from the 2008-2012 National Survey on Drug Use and Health aged 18-64 who had past 12-month MDE (based on criteria specified in the Diagnostic and Statistical Manual of Mental Disorders, Fourth edition) and received treatment for depression. Generalized ordered logistic regression analyses were conducted to estimate the association between the type of treatment providers and perceived helpfulness of depression treatment.
Adults who received depression treatment from either specialty mental health providers alone or from both specialty mental health providers and general medical providers in the past year were more likely to report that treatment helped them. The differences persisted after adjusting for sociodemographic characteristics, comorbid health conditions, receipt of depression medication and severity of depression (adjusted odds ratios across level of perceived helpfulness ranged from 1.63 to 3.96).
This finding calls for greater attention to factors associated with provider type and organizational context that may contribute to differences in perceived helpfulness of depression treatment.
本研究考察了仅接受一般医疗提供者、仅接受专业心理健康提供者或同时接受两者治疗重度抑郁发作(MDE)的患者对治疗的感知效果的差异。
本研究调查了 2008-2012 年全国药物使用和健康调查中 8900 名年龄在 18-64 岁、过去 12 个月有 MDE(根据《精神障碍诊断与统计手册》第四版规定的标准)且接受过抑郁治疗的受访者。采用广义有序逻辑回归分析来估计治疗提供者类型与抑郁治疗的感知效果之间的关联。
过去一年中仅接受专业心理健康提供者、或同时接受专业心理健康提供者和一般医疗提供者治疗的成年人更有可能报告治疗对他们有帮助。在调整了社会人口统计学特征、合并健康状况、接受抗抑郁药物治疗和抑郁严重程度后,这种差异仍然存在(感知效果不同程度的调整比值比范围为 1.63 至 3.96)。
这一发现呼吁更多地关注与提供者类型和组织背景相关的因素,这些因素可能导致对抑郁治疗的感知效果的差异。