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在部分住院项目中,治疗准备情况可预测抑郁症的治疗结果。

Readiness for treatment predicts depression outcomes in a partial hospital program.

作者信息

McCarthy Julie M, Hudson James I, Carol Emily E, Kuller Andrew M, Ramadurai Ramya, Björgvinsson Thröstur, Beard Courtney

机构信息

Division of Psychotic Disorders, McLean Hospital.

Department of Psychiatry, Harvard Medical School.

出版信息

Psychol Serv. 2024 Nov;21(4):947-953. doi: 10.1037/ser0000835. Epub 2024 Jan 11.

Abstract

Evidence-based interventions vary in effectiveness for individuals with depression, which has a large public health burden. Readiness for change or treatment can be an important individual difference predictor of depression outcomes. To inform public service initiatives targeting readiness for treatment, characterizing readiness across settings and levels of care is key. However, limited data exist on the role of readiness for treatment in acute psychiatric settings and in particular, partial hospital programs which are key points in the continuity of inpatient and outpatient care. The present study assessed readiness for treatment in terms of importance, confidence, and motivation to engage in a partial hospital program and tested whether higher levels of readiness were associated with better treatment outcomes among clients with depression. Participants ( = 192) with major depressive disorder rated their readiness for treatment (Readiness Rulers), depression (Patient Health Questionnaire-9), and global improvement (Clinical Global Impression Scale-Improvement Self-Report) while enrolled in a partial hospital program. Generalized linear regression models assessed the effect of baseline readiness on outcomes at discharge, adjusted for baseline level of the outcome, age, sex, race, and ethnicity. Greater baseline readiness predicted reduced depression and better global improvement at discharge. Higher confidence and motivation to engage in treatment, but not importance, were associated with better depression outcomes. Identifying and addressing readiness for treatment by leveraging public health systems and services (e.g., help lines, family interventions) prior to or upon starting a partial hospital program may be useful to maximize gains in treatment. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

摘要

循证干预措施对抑郁症患者的有效性各不相同,而抑郁症有着巨大的公共卫生负担。改变或治疗的准备程度可能是抑郁症治疗结果的一个重要个体差异预测指标。为了为针对治疗准备程度的公共服务举措提供信息,明确不同环境和护理水平下的准备程度是关键。然而,关于治疗准备程度在急性精神科环境中的作用,尤其是在部分医院项目(这是住院和门诊护理连续性的关键点)中的作用,现有数据有限。本研究从参与部分医院项目的重要性、信心和动机方面评估了治疗准备程度,并测试了更高水平的准备程度是否与抑郁症患者更好的治疗结果相关。患有重度抑郁症的参与者( = 192)在参加部分医院项目期间对他们的治疗准备程度(准备程度量表)、抑郁程度(患者健康问卷 - 9)和总体改善情况(临床总体印象量表 - 改善自我报告)进行了评分。广义线性回归模型评估了基线准备程度对出院时结果的影响,并对结果的基线水平、年龄、性别、种族和民族进行了调整。更高的基线准备程度预示着出院时抑郁程度降低和总体改善情况更好。参与治疗的更高信心和动机,而非重要性,与更好的抑郁治疗结果相关。在开始部分医院项目之前或之时,通过利用公共卫生系统和服务(如求助热线、家庭干预)来识别和解决治疗准备程度问题,可能有助于最大限度地提高治疗收益。(PsycInfo数据库记录(c)2024美国心理学会,保留所有权利)

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