Hori Hikaru, Yamato Kentaro
Department of Psychiatry, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan.
JPBU Department of Medical Affairs, Takeda Pharmaceutical Co. Ltd., Tokyo, Japan.
Neuropsychiatr Dis Treat. 2019 Oct 1;15:2821-2832. doi: 10.2147/NDT.S217098. eCollection 2019.
To investigate the current clinical practice of Japanese physicians in the diagnosis and management of major depression (major depressive disorder [MDD]).
Japanese physicians specializing in psychiatry or psychosomatic medicine in the medical database of Nihon Ultmarc Inc. (Chuo-Ku, Tokyo, Japan), who had treated ≥30 patients with MDD in the past month were invited to complete a web-based questionnaire from January 15 to 29, 2018. The questionnaire was comprised of 28 questions pertaining to the physician's background, the criteria and tools used to diagnose MDD during physician-patient consultation, and actual and preferred duration of physician-patient consultation. Responses were given as single answer numerical values or as multiple-choice answers.
From the 518 physicians invited to participate, 340 completed questionnaires were analyzed. Respondents were predominantly male (90%), hospital based (73%), affiliated with the Department of Psychiatry (95%), and members of the Japanese Society of Psychiatry and Neurology (87%). The majority of physicians (84%) agreed that "improvement of cognitive dysfunction caused by major depression is an important factor for patients to return to work" was the most challenging aspect of MDD diagnosis and management. Moreover, 83% of physicians conducted psychological assessments using a cognition evaluation test with most of their patients at the time of MDD diagnosis; the most commonly used tool was the Hasegawa Dementia Scale-Revised. Both hospital-based physicians and general practitioners would prefer to have longer consultations with their patients.
Physicians acknowledge the importance of the assessment and management of cognitive dysfunction in patients with MDD. However, most physicians would prefer to have longer consultation times with their patients for the diagnosis of MDD. In the future, it may be useful to introduce digital tools (eg, THINC-it) for the initial screening of cognitive dysfunction.
调查日本医生在重度抑郁症（重度抑郁障碍[MDD]）诊断和管理方面的当前临床实践。
邀请日本Ultmarc公司（日本东京中央区）医学数据库中专门从事精神病学或身心医学且在过去一个月内治疗过≥30例MDD患者的医生，于2018年1月15日至29日完成一份基于网络的问卷。该问卷由28个问题组成，涉及医生背景、医患咨询期间诊断MDD所使用的标准和工具，以及医患咨询的实际时长和期望时长。回答以单答案数值或多项选择题形式给出。
在受邀参与的518名医生中，分析了340份完成的问卷。受访者主要为男性（90%），以医院为基础（73%），隶属于精神科（95%），并且是日本精神神经学会成员（87%）。大多数医生（84%）认为“改善重度抑郁症引起的认知功能障碍是患者恢复工作的重要因素”是MDD诊断和管理中最具挑战性的方面。此外，83%的医生在MDD诊断时对大多数患者使用认知评估测试进行心理评估；最常用的工具是修订版长谷川痴呆量表。以医院为基础的医生和全科医生都希望与患者进行更长时间的咨询。
医生认识到评估和管理MDD患者认知功能障碍的重要性。然而，大多数医生希望在诊断MDD时与患者进行更长时间的咨询。未来，引入数字工具（如THINC-it）进行认知功能障碍的初步筛查可能会有所帮助。
