Bernd Löwe, MD, Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Hamburg-Eppendorf and Schön Klinik Hamburg Eilbek, Hamburg; Stefan Blankenberg, MD, University Heart Centre, University Medical Centre Hamburg-Eppendorf, Hamburg; Karl Wegscheider, PhD, Department of Biostatistics and Epidemiology, University Medical Centre Hamburg-Eppendorf, Hamburg; Hans-Helmut König, MD MPH, Department of Health Economics and Health Services Research, University Medical Centre Hamburg-Eppendorf, Hamburg; Dirk Walter, MD, Cardiologicum Hamburg, Hamburg; Alexandra M. Murray, DPhil, Benjamin Gierk, MSc, Sebastian Kohlmann, PhD, Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Hamburg-Eppendorf and Schön Klinik Hamburg Eilbek, Hamburg, Germany
Bernd Löwe, MD, Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Hamburg-Eppendorf and Schön Klinik Hamburg Eilbek, Hamburg; Stefan Blankenberg, MD, University Heart Centre, University Medical Centre Hamburg-Eppendorf, Hamburg; Karl Wegscheider, PhD, Department of Biostatistics and Epidemiology, University Medical Centre Hamburg-Eppendorf, Hamburg; Hans-Helmut König, MD MPH, Department of Health Economics and Health Services Research, University Medical Centre Hamburg-Eppendorf, Hamburg; Dirk Walter, MD, Cardiologicum Hamburg, Hamburg; Alexandra M. Murray, DPhil, Benjamin Gierk, MSc, Sebastian Kohlmann, PhD, Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Hamburg-Eppendorf and Schön Klinik Hamburg Eilbek, Hamburg, Germany.
Br J Psychiatry. 2017 Feb;210(2):132-139. doi: 10.1192/bjp.bp.116.184168. Epub 2016 Dec 1.
International guidelines advocate depression screening in patients with coronary heart disease (CHD) and other chronic illnesses, but evidence is lacking.
To test the differential efficacy of written patient-targeted feedback v. no written patient feedback after depression screening.
Patients with CHD or hypertension from three cardiology settings were randomised and screened for depression (ClinicalTrials.gov Identifier: NCT01879111). Compared with the control group, where only cardiologists received written feedback, in the intervention group both cardiologists and patients received written feedback regarding depression status. Depression severity was measured 1 month (primary outcome) and 6 months after screening.
The control group (n = 220) and the patient-feedback group (n = 155) did not differ in depression severity 1 month after screening. Six months after screening, the patient-feedback group showed significantly greater improvements in depression severity and was twice as likely to seek information about depression compared with the control group.
Patient-targeted feedback in addition to screening has a significant but small effect on depression severity after 6 months and may encourage patients to take an active role in the self-management of depression.
国际指南提倡对冠心病（CHD）和其他慢性病患者进行抑郁筛查，但证据不足。
检验抑郁筛查后提供书面患者针对性反馈与不提供书面患者反馈的差异疗效。
从三个心脏病学环境中随机抽取 CHD 或高血压患者进行抑郁筛查（ClinicalTrials.gov 标识符：NCT01879111）。与仅心内科医生收到书面反馈的对照组相比，在干预组中，心内科医生和患者都收到了关于抑郁状况的书面反馈。在筛查后 1 个月（主要结局）和 6 个月测量抑郁严重程度。
筛查后 1 个月，对照组（n=220）和患者反馈组（n=155）的抑郁严重程度无差异。筛查后 6 个月，患者反馈组的抑郁严重程度显著改善，且与对照组相比，患者寻求抑郁相关信息的可能性是对照组的两倍。
除筛查外，患者针对性反馈对 6 个月后的抑郁严重程度有显著但较小的影响，可能鼓励患者在抑郁的自我管理中发挥积极作用。
