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, Japan.
Department of Psychiatry, Tsugaru General Hospital, Goshogawara, Japan.
Neuropsychiatr Dis Treat. 2018 May 22;14:1319-1327. doi: 10.2147/NDT.S158254. eCollection 2018.
To reveal characteristics of understanding of depression among older patients, we reanalyzed the data from a previous study of patients who were administered antidepressants.
A total of 424 outpatients were enrolled in this study. We used an original self-administered questionnaire consisting of eight items: depressive symptoms, the course of depression, the cause of depression, the treatment plan, the duration of antidepressant use, how to discontinue antidepressants, the side effects of antidepressants, and psychotherapy. Each item consisted of the following two questions: "Have you received an explanation from the doctor in charge?" and "How much do you understand about your treatment?". The level of understanding was rated on a scale of 0-10 (11 anchor points). Subjects were divided into two groups: younger patients who were <65 years of age and older patients who were ≥65 years of age.
Older patients with depression showed lower levels of understanding of depression and did not receive sufficient psychoeducation from their physicians, but their understanding of depression might not be associated with their remission. In the younger group, the scores of understanding of the course of depression, the treatment plan, how to discontinue antidepressants, and psychotherapy items, and the total understanding score of remitters, were significantly higher than those of non-remitters. In contrast, there were no significant differences in the items score or total score between remitters and non-remitters in the older group.
Older patients showed lower levels of understanding of depression and did not appear to receive sufficient psychoeducation, but their understanding of depression might not be associated with their remission.
为揭示老年患者对抑郁症的理解特点，我们重新分析了之前一项针对服用抗抑郁药患者的研究数据。
本研究共纳入424名门诊患者。我们使用了一份由八个项目组成的原创自填式问卷：抑郁症状、抑郁症病程、抑郁症病因、治疗方案、抗抑郁药使用时长、如何停用抗抑郁药、抗抑郁药副作用以及心理治疗。每个项目由以下两个问题组成：“您是否从主管医生那里得到过解释？”以及“您对自己的治疗了解多少？”。理解程度按0至10分（共11个锚点）进行评分。受试者被分为两组：年龄小于65岁的年轻患者和年龄大于或等于65岁的老年患者。
老年抑郁症患者对抑郁症的理解水平较低，且未从医生那里获得足够的心理教育，但他们对抑郁症的理解可能与病情缓解无关。在年轻组中，缓解者在抑郁症病程、治疗方案、如何停用抗抑郁药以及心理治疗项目的理解得分，以及总理解得分，均显著高于未缓解者。相比之下，老年组中缓解者与未缓解者在项目得分或总分上没有显著差异。
老年患者对抑郁症的理解水平较低，似乎未获得足够的心理教育，但他们对抑郁症的理解可能与病情缓解无关。
