Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, PO Box 9510, Morgantown, WV, 26506-9510, USA.
Psychiatr Q. 2018 Mar;89(1):129-140. doi: 10.1007/s11126-017-9520-0.
Depression treatment has been proven to relieve depressive symptoms and pain and may therefore improve the health-related quality of life (HRQoL) among adults with arthritis. The objective of the current study was to examine the HRQoL associated with depression treatment among adults with arthritis and depression. A retrospective longitudinal cohort study design using data from the Medical Expenditure Panel Survey (2009-2012) was adopted. The study sample consisted of adults (≥ 21 years) with co-existing arthritis and depression (N = 1692). Depression treatment was categorized into: antidepressants only, psychotherapy with or without antidepressants, and neither antidepressants nor psychotherapy. Multivariable Ordinary Least Square (OLS) regressions, which controlled for observed selection bias with inverse probability treatment weights (IPTW) were built to examine the association between depression treatment categories and the HRQoL scores. The OLS regression controlled for factors in the biological, psychological and social domains that may affect HRQoL. A majority of individuals reported taking antidepressants only (52%), 24.4% reported receiving psychotherapy with or without antidepressants and 23% did not receive either antidepressants or psychotherapy. In multivariable OLS regression with IPTWs, adults using only antidepressants had marginally higher physical component summary scores (beta = 0.96, p value = 0.096) compared to no depression treatment. There were no significant associations between depression categories and mental component summary scores. HRQoL was not affected by depression treatment in adults with coexisting arthritis and depression. Improvement in HRQoL may require a collaborative care approach and such intense care may not be replicated in real-world practice settings.
抑郁症治疗已被证明可缓解抑郁症状和疼痛，因此可能会改善关节炎患者的健康相关生活质量（HRQoL）。本研究的目的是研究与关节炎合并抑郁症成人的抑郁症治疗相关的 HRQoL。采用了回顾性纵向队列研究设计，使用了医疗支出面板调查（2009-2012 年）的数据。研究样本包括患有共存关节炎和抑郁症的成年人（≥21 岁）（N=1692）。将抑郁症治疗分为：仅使用抗抑郁药、联合或不联合抗抑郁药的心理治疗、以及既不使用抗抑郁药也不使用心理治疗。建立了多变量普通最小二乘（OLS）回归模型，使用逆概率治疗权重（IPTW）控制观察到的选择偏差，以检验抑郁症治疗类别与 HRQoL 评分之间的关联。OLS 回归控制了可能影响 HRQoL 的生物、心理和社会领域的因素。大多数人报告仅服用抗抑郁药（52%），24.4%报告接受了联合或不联合抗抑郁药的心理治疗，23%的人既未服用抗抑郁药也未接受心理治疗。在使用 IPTW 的多变量 OLS 回归中，与未接受抑郁症治疗的成年人相比，仅使用抗抑郁药的成年人的身体成分综合评分略有升高（β=0.96，p 值=0.096）。抑郁症类别与心理成分综合评分之间没有显著关联。在患有共存关节炎和抑郁症的成年人中，抑郁症治疗并未影响 HRQoL。HRQoL 的改善可能需要协同护理方法，而这种强化护理在现实实践环境中可能无法复制。
