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氯胺酮治疗抑郁症:探索患者观点的定性研究

Ketamine treatment for depression: qualitative study exploring patient views.

作者信息

Jilka Sagar, Odoi Clarissa Mary, Wilson Emma, Meran Sazan, Simblett Sara, Wykes Til

机构信息

Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; and South London and Maudsley NHS Foundation Trust, UK.

Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK.

出版信息

BJPsych Open. 2021 Jan 11;7(1):e32. doi: 10.1192/bjo.2020.165.

DOI:10.1192/bjo.2020.165
PMID:33427156
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8058884/
Abstract

BACKGROUND

Ketamine is a new and promising treatment for depression but comes with challenges to implement because of its potential for abuse.

AIMS

We sought the views of patients to inform policy and practical decisions about the clinical use of ketamine before large-scale roll-out is considered.

METHOD

This qualitative study used three focus groups and three validation sessions from 14 patients with prior diagnoses of depression but no experience of ketamine treatment. Focus groups explored their views about clinical use of ketamine and the best way for ketamine to be administered and monitored. The qualitative data were analysed by three service-user researchers using thematic analysis.

RESULTS

Five themes were generated: changing public perceptions, risks, monitoring, privacy and data protection, and practical aspects. Participants were conscious of the stigma attached to ketamine as a street drug and wanted better public education, and evidence on the safety of ketamine after long-term use. They felt that monitoring was required to provide evidence for ketamine's safe use and administration, but there were concerns about the misuse of this information. Practical aspects included discussions about treatment duration, administration and accessibility (for example who would receive it, under what criteria and how).

CONCLUSIONS

Patients are enthusiastic about ketamine treatment but need more information before national roll-out. The wider societal impact of ketamine treatment also needs to be considered and patients need to be part of any future roll-out to ensure its success.

摘要

背景

氯胺酮是一种新型且有前景的抑郁症治疗方法,但因其存在滥用可能性,在实施过程中面临挑战。

目的

在考虑大规模推广之前,我们征求患者的意见,以为氯胺酮临床使用的政策和实际决策提供参考。

方法

这项定性研究采用了三个焦点小组以及来自14名先前被诊断为抑郁症但无氯胺酮治疗经验的患者的三次验证会议。焦点小组探讨了他们对氯胺酮临床使用的看法以及氯胺酮给药和监测的最佳方式。定性数据由三名服务使用者研究人员采用主题分析法进行分析。

结果

产生了五个主题:公众认知的改变、风险、监测、隐私和数据保护以及实际问题。参与者意识到氯胺酮作为街头毒品所带来的污名,并希望得到更好的公众教育以及长期使用后氯胺酮安全性的证据。他们认为需要进行监测以提供氯胺酮安全使用和给药的证据,但担心这些信息会被滥用。实际问题包括关于治疗持续时间、给药方式和可及性的讨论(例如谁将接受治疗、依据什么标准以及如何接受治疗)。

结论

患者对氯胺酮治疗充满热情,但在全国推广之前需要更多信息。还需要考虑氯胺酮治疗对更广泛社会的影响,并且患者需要参与未来的任何推广活动以确保其成功。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e2ec/8058884/72f18998a955/S2056472420001659_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e2ec/8058884/72f18998a955/S2056472420001659_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e2ec/8058884/72f18998a955/S2056472420001659_fig1.jpg

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BMJ. 2019 Dec 20;367:l7069. doi: 10.1136/bmj.l7069.
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Ketamine and depression: a narrative review.氯胺酮与抑郁症:一篇叙述性综述。
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Beliefs and Perceived Barriers Regarding Psychedelic-assisted Therapy in a Pilot Study of Service Members and Veterans With a History of Traumatic Brain Injury.在一项针对有创伤性脑损伤病史的军人和退伍军人的试点研究中,关于迷幻辅助治疗的信念和感知障碍。
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