Slofstra Christien, Booij Sanne H, Rogier Hoenders H J, Castelein Stynke
Lentis Research, Groningen, Hereweg 80, 9700 AB Groningen, The Netherlands.
Lentis Psychiatric Institute, Center for Integrative Psychiatry, Hereweg 76, 9700 AB Groningen, The Netherlands.
J Pers Oriented Res. 2019 Dec 30;5(2):1-8. doi: 10.17505/jpor.2019.10. eCollection 2019.
Responses to evidence-based interventions for depression are divergent: Some patients benefit more than others during treatment and some do not benefit at all or even deteriorate. Tailoring interventions to the individual may improve outcomes. However, such personalization of evidence-based treatment in depression requires investigation of individual outcomes and the individual trajectories towards these outcomes. This theoretical paper provides a critical reflection on individual outcomes of depression treatment. First, it is argued that outcomes should be broadened, from a focus on mainly depressive symptomatology to recovery in different domains. It is acknowledged that recovery from depression reflects a personal journey that differs from person to person. Second, outcome measures should be lengthened beyond the acute treatment phase, taking a lifetime perspective on depression. The challenge then is to discover which trajectories of what measures during what interventions result in personalized sustainable recovery and for whom. Routine outcome monitoring systems may be used to inform this quest towards assessment of personalized sustainable therapeutic outcomes. Adaptations to broaden and lengthen measurements in routine outcome monitoring systems are proposed to identify predictors of personalized sustainable recovery. Routine outcome monitoring systems may eventually be used to implement personalized treatments for depression that result in personalized sustainable recovery.
一些患者在治疗期间比其他患者受益更多，一些患者根本没有受益甚至病情恶化。根据个体情况调整干预措施可能会改善治疗效果。然而，这种抑郁症循证治疗的个性化需要对个体治疗效果以及达成这些效果的个体轨迹进行研究。这篇理论性论文对抑郁症治疗的个体效果进行了批判性反思。首先，有人认为治疗效果的范围应扩大，从主要关注抑郁症状转变为关注不同领域的康复。人们认识到，从抑郁症中康复反映的是因人而异的个人历程。其次，效果衡量应延长至急性治疗阶段之后，从一生的角度看待抑郁症。接下来的挑战是，要发现何种干预措施期间的哪些衡量指标轨迹能带来个性化的可持续康复，以及适用于哪些人。常规效果监测系统可用于为评估个性化可持续治疗效果的探索提供信息。建议对常规效果监测系统进行调整，以扩大和延长衡量范围，从而识别个性化可持续康复的预测因素。常规效果监测系统最终可用于实施能带来个性化可持续康复的抑郁症个性化治疗。
