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有死亡意愿的抑郁老年患者:精神治疗师的年龄和健康偏见的实验证据。

Depressed Older Patients with Death Wishes: Experimental Evidence for Psychotherapists' Age and Health Bias.

机构信息

MSB Medical School Berlin, Private university in Berlin , Berlin, Germany.

出版信息

Clin Gerontol. 2021 Mar-Apr;44(2):154-159. doi: 10.1080/07317115.2020.1856265. Epub 2020 Dec 4.

DOI:10.1080/07317115.2020.1856265
PMID:33275085
Abstract

: When psychotherapists encounter an older patient with depression and death wishes, especially when burdened by physical illness, they may be subject to judgmental biases. This study investigates how this group of patients with highest suicide risk may experience discrimination both on age health status. : Using a 2 × 2 [chronological age x physical health status] vignette design, psychotherapists (N = 147) were randomly presented with one of the four variants of a case describing a patient with depression and death wishes (i.e., 78 years old + poor physical health; 78 years old + normal physical health; 48 years old + poor physical health; 48 years old + normal physical health). Afterward, participants' attitudes toward the case were assessed. : In case of the hypothetical patient's old age and poor health status, participants did not underestimate the pathological significance of his death wishes, but nevertheless showed less optimistic treatment attitudes and less confidence in psychotherapeutic treatment. : Psychotherapists' age bias and health bias may serve as two potentially fatal factors influencing the provision of mental health services. : Psychotherapists may contribute to better mental health-care provision of older adults with depression and the prevention of late-life suicide by increasing awareness of their age and health bias.

摘要

当心理治疗师遇到一位有抑郁和自杀念头的老年患者,尤其是当患者还患有身体疾病时,他们可能会受到判断偏见的影响。本研究旨在探讨这群自杀风险最高的患者在年龄和健康状况方面可能会经历怎样的歧视。

本研究采用 2×2(年龄×身体健康状况)情境设计,随机向 147 名心理治疗师展示描述一位有抑郁和自杀念头的患者的四种情境变体之一(即 78 岁+身体不好;78 岁+身体健康;48 岁+身体不好;48 岁+身体健康)。之后,评估参与者对案例的态度。

在假设患者年龄较大且健康状况不佳的情况下,参与者并没有低估他自杀念头的病理性,但他们对治疗的态度较为悲观,对心理治疗的信心也较低。

心理治疗师的年龄偏见和健康偏见可能是影响心理健康服务提供的两个潜在致命因素。

通过提高对其年龄和健康偏见的认识,心理治疗师可以为有抑郁的老年患者提供更好的心理健康服务,并预防老年自杀。

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引用本文的文献

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[Ageism "in the mind" as a risk factor for suicidal ideation in old age].[“脑海中的年龄歧视”作为老年人自杀意念的一个风险因素]
Z Gerontol Geriatr. 2025 Feb;58(1):10-16. doi: 10.1007/s00391-024-02396-z. Epub 2025 Jan 23.
2
[Feasibility, Practicability, and Acceptance of Outpatient Psychotherapy for Home-living Older Adults with Depression in Need of Care in Germany].[德国居家需要护理的老年抑郁症患者门诊心理治疗的可行性、实用性和可接受性]
Psychiatr Prax. 2023 May;50(4):196-203. doi: 10.1055/a-1960-4723. Epub 2022 Nov 23.