Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
BMC Psychiatry. 2018 Nov 15;18(1):366. doi: 10.1186/s12888-018-1936-z.
Treatment of depression in cardiac patients is difficult. Patients' illness beliefs regarding depression are associated with outcomes. The aim of the mixed-methods study was to test whether patients in routine care for depression differ from patients with depression in routine care for cardiac diseases regarding illness beliefs about depression.
A consecutive sample of n = 217 patients with depressive disorder was recruited from routine care for depression (N = 148) and routine care for cardiac diseases (N = 69). Beliefs about depression were measured by the Brief-Illness Perception Questionnaire. Causal beliefs were categorized using qualitative methods. To investigate differences regarding other illness beliefs, we performed an ANCOVA controlling for sociodemographic and clinical differences by propensity score matching.
Patients in routine care for cardiac diseases attributed their depression more often to physical illnesses (48% vs. 16%) and less often to their self (30% vs. 47%), problems at work (25% vs. 35%), childhood (25% vs. 30%), and negative life events (19% vs. 25%) in contrast to patients in routine care for depression. Patients in routine care for cardiac diseases reported beliefs of lower disability, burden, and treatment-control and of higher self-control in contrast to patients in routine care for depression.
Illness beliefs especially causal beliefs differ between patients in routine care for cardiac diseases and routine care for depression. Future research should investigate effects of these illness beliefs. We recommend exploring patients' illness beliefs about depression in routine care for cardiac diseases and routine care for depression.
治疗心脏病患者的抑郁症较为困难。患者对抑郁症的病感信念与治疗结局相关。本混合方法研究旨在检验常规治疗抑郁的患者与常规治疗心脏疾病的患者在抑郁症病感信念上是否存在差异。
从常规治疗抑郁（n=148）和常规治疗心脏疾病（n=69）中连续纳入了 217 例患有抑郁障碍的患者。采用Brief-Illness Perception Questionnaire 测量抑郁信念。采用定性方法对病因信念进行分类。为了探究其他病感信念方面的差异，我们通过倾向评分匹配控制了社会人口学和临床差异后进行了协方差分析。
与常规治疗抑郁的患者相比，常规治疗心脏疾病的患者更常将抑郁归因于躯体疾病（48%比 16%），而较少归因于自身（30%比 47%）、工作问题（25%比 35%）、童年（25%比 30%）和负性生活事件（19%比 25%）。与常规治疗抑郁的患者相比，常规治疗心脏疾病的患者报告的残疾、负担、治疗控制和自我控制程度较低，而自我控制程度较高。
常规治疗心脏疾病和常规治疗抑郁的患者之间的病感信念，特别是病因信念存在差异。未来的研究应调查这些病感信念的影响。我们建议在常规治疗心脏疾病和常规治疗抑郁中探究患者对抑郁症的病感信念。
