Edlund Mark J, Pettiford Adrianne G, Hampton Joel, Forman-Hoffman Valerie L, Ault Kimberly L, Colpe Lisa J, Hedden Sarra L
Dr. Edlund and Dr. Forman-Hoffman are with the Behavioral and Urban Health Program, Dr. Pettiford is with the Children and Families Program, and Mr. Hampton and Dr. Ault are with the Division of Statistical and Data Sciences, RTI International, Research Triangle Park, North Carolina (e-mail:
Psychiatr Serv. 2015 Oct;66(10):1064-73. doi: 10.1176/appi.ps.201400018. Epub 2015 Jun 15.
The study investigated perceived helpfulness of counseling or medication in a national sample of adolescents with a major depressive episode.
Secondary data analysis of the National Survey on Drug Use and Health was conducted. The sample comprised adolescents (ages 12-17) with a past-year major depressive episode who reported receiving either counseling and no medication (N=2,000) or medication and counseling (N=1,300) for depression in the past year. Adolescents who received counseling only evaluated the helpfulness of counseling, and adolescents who received medication and counseling evaluated the helpfulness of medication. Responses were analyzed by using descriptive statistics and ordered logistic regression models.
Among adolescents who received counseling only, 10% reported that counseling was extremely helpful, 22% that it helped a lot, 25% that it helped some, 24% that it helped a little, and 20% that it was not at all helpful. Among adolescents who received medication and counseling, 17% reported that medication was extremely helpful, 30% that it helped a lot, 22% that it helped somewhat, 16% that it helped a little, and 15% that it was not at all helpful. In adjusted models, adolescents with greater parental support and fewer than two delinquent behaviors in the past year were more likely to endorse treatment as helpful.
About 32% to 47% of adolescents in the general population reported that depression treatment was extremely helpful or helped a lot. This is substantially lower than response rates in clinical trials. The reasons for these divergent findings merit further investigation.
本研究调查了全国范围内患有重度抑郁发作的青少年样本中,咨询或药物治疗的感知有效性。
对全国药物使用和健康调查进行二次数据分析。样本包括过去一年有重度抑郁发作的青少年(12 - 17岁),他们报告在过去一年中接受了咨询但未用药(N = 2000)或同时接受了药物治疗和咨询(N = 1300)。仅接受咨询的青少年评估咨询的有效性,接受药物治疗和咨询的青少年评估药物治疗的有效性。使用描述性统计和有序逻辑回归模型分析回答。
在仅接受咨询的青少年中,10%报告咨询极其有效,22%报告非常有帮助,25%报告有些帮助,24%报告有一点帮助,20%报告完全没有帮助。在接受药物治疗和咨询的青少年中,17%报告药物极其有效,30%报告非常有帮助,22%报告有些帮助,16%报告有一点帮助,15%报告完全没有帮助。在调整模型中,过去一年得到更多父母支持且有少于两种违法行为的青少年更有可能认可治疗是有帮助的。
普通人群中约32%至47%的青少年报告抑郁治疗极其有效或非常有帮助。这大大低于临床试验中的反应率。这些不同结果的原因值得进一步研究。