Kan Kaying, Jörg Frederike, Buskens Erik, Schoevers Robert A, Alma Manna A
University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, Interdisciplinary Centre for Psychopathology and Emotion Regulation, the Netherlands.
GGZ Friesland, Research Department, Leeuwarden; and University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, Interdisciplinary Centre for Psychopathology and Emotion Regulation, the Netherlands.
BJPsych Open. 2020 May 4;6(3):e44. doi: 10.1192/bjo.2020.27.
Although symptomatic remission is considered the optimal outcome in depression, this is not always achieved. Furthermore, symptom indicators do not fully capture patients' and clinicians' perspectives on remission. Broader indicators of (partial) remission from depression should be considered.
To investigate relevant outcomes of depression treatment in specialist care from patients' and clinicians' perspectives and to investigate whether these perspectives differ from each other.
Three focus groups with 11 patients with depression and seven semi-structured interviews with clinicians were conducted exploring their perspectives on remission. All interviews were audio-recorded and transcribed verbatim. We analysed the transcripts thematically using the phenomenologist approach.
Independently, both patients and clinicians perceived the following outcomes relevant: restoring social functioning and interpersonal relations, regaining quality of life and achieving personal goals. All clinicians emphasised symptom reduction and satisfaction with treatment as relevant outcomes, whereas the former was not an obvious theme in patients. Unlike clinicians, patients made a clear distinction between treatment outcomes in first versus recurrent/chronic depression.
Classically defined study outcomes based on symptom resolution only partly reflect issues considered important by patients and clinicians in specialist depression treatment. Incorporating patients' and clinicians' perspectives in the development of measurable end-points makes them more suitable for use in trials and subsequent translation to clinical practice. Furthermore, evaluating patients' perspectives on treatment outcomes helps in the development of tailored interventions according to patients' needs.
尽管症状缓解被认为是抑郁症的最佳治疗结果，但并非总能实现。此外，症状指标并不能完全体现患者和临床医生对缓解的看法。应考虑更广泛的抑郁症（部分）缓解指标。
从患者和临床医生的角度调查专科护理中抑郁症治疗的相关结果，并调查这些观点是否彼此不同。
对11名抑郁症患者进行了3个焦点小组访谈，并对临床医生进行了7次半结构化访谈，探讨他们对缓解的看法。所有访谈均进行录音并逐字转录。我们采用现象学方法对转录本进行了主题分析。
患者和临床医生都独立地认为以下结果是相关的：恢复社会功能和人际关系、恢复生活质量以及实现个人目标。所有临床医生都强调症状减轻和对治疗的满意度是相关结果，而在患者中，前者并非明显的主题。与临床医生不同，患者明确区分了首次发作与复发/慢性抑郁症的治疗结果。
仅基于症状缓解的经典定义的研究结果仅部分反映了患者和临床医生在专科抑郁症治疗中认为重要的问题。在制定可测量的终点时纳入患者和临床医生的观点，使其更适合用于试验并随后转化为临床实践。此外，评估患者对治疗结果的看法有助于根据患者需求制定个性化干预措施。
