Stein Michael D, Santiago Rivera Olga J, Anderson Bradley J, Bailey Genie L
Health Law, Policy & Management, Boston University School of Public Health, Boston, Massachusetts.
Butler Hospital, Providence, Rhode Island.
Am J Addict. 2017 Jun;26(4):395-399. doi: 10.1111/ajad.12554. Epub 2017 Apr 28.
Depression is common among persons with opioid use disorder. We examined the perceived need for depression treatment (PNDT) among opioid-dependent patients and the relationship of PNDT to depression screening result.
Between May and December 2015, we surveyed consecutive persons (n = 440) seeking inpatient opioid detoxification. We used the Patient Health Questionnaire-2 (PHQ-2) to screen for depression. To assess perceived need for depression services, participants were asked, "Do you believe you should be treated for depression?" Response options were recorded into four categories: "Not Depressed (ND)," "Perceive Need for Depression Treatment (PNDT)," "Depressed/Don't Want Treatment," and "Currently Treated."
Participants' mean age was 32.3 (±8.7) years; 70.7% were male. Nearly two out of three persons screened positive for depression yet only 8.2% were being treated for depression prior to admission. Screening positive for depression was associated with a 2.95 (95%CI 1.82-4.81, p < .005) fold increase in the expected odds of PNDT. But nearly half of those depressed (48%) did not perceive the need for treatment. Approximately 40% of the participants (n = 177) perceived that they were not depressed; of these persons, 52% screened positive for depression.
Detoxification program staff should screen patients for depression, and if a clinical diagnosis is confirmed, discuss treatment options, exploring the level of interest in mental health treatment for depression.
Screening for and addressing depression, including patients' interest in treatment, should be central to post-detoxification aftercare planning. (Am J Addict 2017;26:395-399).
抑郁症在阿片类药物使用障碍患者中很常见。我们研究了阿片类药物依赖患者对抑郁症治疗的感知需求(PNDT)以及PNDT与抑郁症筛查结果的关系。
2015年5月至12月期间,我们对连续寻求住院阿片类药物脱毒治疗的患者(n = 440)进行了调查。我们使用患者健康问卷-2(PHQ-2)筛查抑郁症。为了评估对抑郁症服务的感知需求,我们询问参与者:“你认为你应该接受抑郁症治疗吗?”回答选项被记录为四类:“未患抑郁症(ND)”、“感知到对抑郁症治疗的需求(PNDT)”、“患抑郁症/不想接受治疗”和“正在接受治疗”。
参与者的平均年龄为32.3(±8.7)岁;70.7%为男性。近三分之二的人抑郁症筛查呈阳性,但入院前只有8.2%的人正在接受抑郁症治疗。抑郁症筛查呈阳性与PNDT预期几率增加2.95倍(95%CI 1.82 - 4.81,p <.005)相关。但近一半的抑郁症患者(48%)没有意识到需要治疗。大约40%的参与者(n = 177)认为自己没有患抑郁症;在这些人中,52%的人抑郁症筛查呈阳性。
脱毒治疗项目工作人员应该对患者进行抑郁症筛查,如果确诊临床诊断,应讨论治疗方案,探索对抑郁症心理健康治疗的兴趣程度。
筛查和解决抑郁症问题,包括患者对治疗的兴趣,应该是脱毒后后续护理计划的核心。(《美国成瘾杂志》2017年;26:395 - 399)