Alang Sirry, McAlpine Donna
Department of Sociology and Anthropology, and Program in Health, Medicine, and Society, Lehigh University, Bethlehem, PA, USA.
Division of Health Policy & Management, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
Health Serv Insights. 2020 May 6;13:1178632920918288. doi: 10.1177/1178632920918288. eCollection 2020.
Patient-reported outcomes of mental health treatment, such as perceived effectiveness, are important. They indicate whether treatment is perceived to reduce symptoms and minimize psychiatric disability. Outpatient treatment for depression typically includes medication or counseling, either alone or in combination. This study examines the relationship between treatment modality and perceived effectiveness of treatment. Using a sample of adults who received outpatient treatment for depression from the 2015-2016 National Survey on Drug Use and Health (N = 4169), logistic regressions estimated the odds of rating treatment as effective among persons who received medication only, counseling only, and a combination of medication and counseling. There were no differences in perceived effectiveness between counseling only and medication only. However, receiving both was associated with greater odds of rating treatment as effective. Poor self-rated health and severe mental illness were associated with lower perceived effectiveness of medication. Those with substance use problems had lower odds of rating counseling and both counseling and medication as effective. A combined treatment for depression may be perceived as better than single-modality treatment. Therefore, there might be benefits to increasing access to both forms of treatment for persons less likely to rate either single modality as effective.
患者报告的心理健康治疗结果,如感知到的有效性,很重要。它们表明治疗是否被认为能减轻症状并使精神残疾最小化。抑郁症的门诊治疗通常包括单独或联合使用药物或咨询。本研究考察了治疗方式与治疗感知有效性之间的关系。利用2015 - 2016年全国药物使用和健康调查中接受抑郁症门诊治疗的成年人样本(N = 4169),逻辑回归估计了仅接受药物治疗、仅接受咨询以及药物与咨询联合治疗的人群将治疗评为有效的概率。仅接受咨询和仅接受药物治疗在感知有效性上没有差异。然而,同时接受两者与将治疗评为有效的更高概率相关。自我健康评分低和患有严重精神疾病与药物治疗的较低感知有效性相关。有物质使用问题的人将咨询以及咨询与药物联合治疗评为有效的概率较低。抑郁症的联合治疗可能被认为比单一治疗方式更好。因此,对于那些不太可能将单一治疗方式评为有效的人,增加两种治疗方式的可及性可能会有好处。