Tomita Tetsu, Kudo Shuhei, Sugawara Norio, Fujii Akira, Tsuruga Koji, Sato Yasushi, Ishioka Masamichi, Nakamura Kazuhiko, Yasui-Furukori Norio
Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki.
Department of Psychiatry, Tsugaru General Hospital, Goshogawara.
Neuropsychiatr Dis Treat. 2018 Feb 12;14:505-510. doi: 10.2147/NDT.S156797. eCollection 2018.
We analyzed data on the understanding of depression among patients who were prescribed antidepressants to determine when psychoeducation should be provided.
A total of 424 outpatients were enrolled in this study. We used an original self-administered questionnaire consisting of eight categories: (A) depressive symptoms, (B) the course of depression, (C) causes of depression, (D) the treatment plan, (E) the duration of antidepressant use, (F) discontinuation of antidepressants, (G) the side effects of antidepressants, and (H) psychotherapy. Each category was assessed with the following two questions: "Have you received an explanation of this topic from the doctor in charge?" and "How much do you understand about your treatment?" The level of understanding of patients was rated on a scale from 0 to 10 (no understanding to full understanding; 11 anchor points). Symptoms were evaluated using the Quick Inventory for Depressive Symptomatology, Japanese version (QIDS-J) and other scales. Participants were divided into two groups: patients receiving psychoeducation at their first visit vs patients receiving psychoeducation after their first visit.
Of the patients who had received an explanation of each psychoeducation item, a greater proportion were in the first visit group than in the after first visit group for nearly all items. Compared with the after first visit group, the first visit group showed a better understanding of each psychoeducation item and significantly lower QIDS scores for those receiving explanations of Items A and C. There was no significant difference between the two groups in remittance rates.
Psychoeducation on depression, especially regarding the symptoms and causes of depression, should be provided at patients' first visit.
我们分析了服用抗抑郁药患者对抑郁症的理解数据,以确定何时应提供心理教育。
本研究共纳入424名门诊患者。我们使用了一份原创的自填式问卷,包括八个类别:(A)抑郁症状,(B)抑郁病程,(C)抑郁原因,(D)治疗计划,(E)抗抑郁药使用时长,(F)停用抗抑郁药,(G)抗抑郁药副作用,以及(H)心理治疗。每个类别通过以下两个问题进行评估:“你是否从主治医生那里得到过关于这个主题的解释?”以及“你对自己的治疗了解多少?”患者的理解程度按0至10分的量表进行评分(从完全不理解到完全理解;共11个锚点)。使用抑郁症状快速自评量表(日本版,QIDS-J)和其他量表评估症状。参与者分为两组:首次就诊时接受心理教育的患者与首次就诊后接受心理教育的患者。
在接受了各项心理教育项目解释的患者中,几乎所有项目首次就诊组的比例都高于首次就诊后组。与首次就诊后组相比,首次就诊组对每个心理教育项目的理解更好,并且对于接受了项目A和C解释的患者,其QIDS评分显著更低。两组的缓解率没有显著差异。
应在患者首次就诊时提供关于抑郁症的心理教育,尤其是关于抑郁症状和原因的教育。