Chin Shannon, Lim Kokkwang, Yap Chee Khong, Wong Meiyin
Department of Psychology, James Cook University, Singapore.
Psychology Services, National Healthcare Group Polyclinics, Singapore.
Indian J Psychol Med. 2020 Jan 6;42(1):39-45. doi: 10.4103/IJPSYM.IJPSYM_442_18. eCollection 2020 Jan-Feb.
Depression has been identified as the most common mental illness in Singapore. To address this growing concern, the current study focused on the population within the primary care setting since depression has been demonstrated to be highly prevalent in these patients. This study examined the possible predictors of outcome expectancy based on illness perception and depression severity.
One hundred and one adult patients with depressive symptoms in primary care were recruited for a cross-sectional study. Positive outcome expectancy was measured using the Depression Change Expectancy Scale, and illness perception was measured using the Illness Perception Questionnaire Mental Health. Depression severity was derived from the Patient Health Questionnaire-9 scores extracted from the participants' medical records. Regression and mediation analyses were applied to explore possible predictors of positive outcome expectancy.
Regression analysis demonstrated that symptom severity, and specific dimensions under illness perception (i.e., perception of chronicity, perception of personal control, and perception of treatment control) were the most significant predictors of positive outcome expectancy. Mediation analysis found that symptom severity partially mediated the relationship between perception of chronicity and positive outcome expectancy.
Pharmacotherapy, interventions from allied health professionals, and psychotherapeutic interventions (e.g., strategies from positive psychology, solution-focused therapy, and strengths-based cognitive behavioral therapy) that aim to directly alleviate depressive symptoms as well as improve the perceptions of chronicity, personal control, and treatment control could potentially enhance treatment benefits in primary care patients with depression.
抑郁症已被确认为新加坡最常见的精神疾病。为应对这一日益严重的问题，本研究聚焦于基层医疗环境中的人群，因为抑郁症在这些患者中已被证明高度普遍。本研究基于疾病认知和抑郁严重程度，考察了结果期望的可能预测因素。
招募了101名基层医疗中患有抑郁症状的成年患者进行横断面研究。使用抑郁变化期望量表测量积极结果期望，使用心理健康疾病认知问卷测量疾病认知。抑郁严重程度来自从参与者病历中提取的患者健康问卷-9得分。应用回归分析和中介分析来探索积极结果期望的可能预测因素。
回归分析表明，症状严重程度以及疾病认知中的特定维度（即慢性认知、个人控制认知和治疗控制认知）是积极结果期望的最显著预测因素。中介分析发现，症状严重程度部分中介了慢性认知与积极结果期望之间的关系。
旨在直接缓解抑郁症状以及改善慢性认知、个人控制认知和治疗控制认知的药物治疗、专职医疗人员的干预以及心理治疗干预（例如积极心理学策略、聚焦解决疗法和基于优势的认知行为疗法），可能会提高基层医疗中抑郁症患者的治疗效果。
