临床医生与同伴支持问题解决疗法对农村老年抑郁症患者的比较效果。
Comparative Effectiveness of Clinician- Versus Peer-Supported Problem-Solving Therapy for Rural Older Adults With Depression.
机构信息
Institute for Health and Aging, University of California, San Francisco, San Francisco (Hollister, Crabb); Center for Care Research South, Department of Health and Nursing Sciences, University of Agder, Agder, Norway (Hollister); Accelerating the Reach and Impact of Treatments for Youth and Adults With Mental Illness (ALACRITY) Center, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Areán).
出版信息
Psychiatr Serv. 2024 Sep 1;75(9):925-928. doi: 10.1176/appi.ps.20230027. Epub 2024 Apr 23.
OBJECTIVE
Self-guided and peer-supported treatments for depression among rural older adults may address some common barriers to treatment. This pilot study compared the effect on depression of peer-supported, self-guided problem-solving therapy (SG-PST) with case management problem-solving therapy (CM-PST) among older adults in rural California.
METHODS
Older adults with depression (N=105) received an introductory PST session with a clinician, followed by 11 sessions of CM-PST with a clinician (N=85) or SG-PST with a peer counselor (N=20).
RESULTS
Both interventions resulted in clinically significant improvement in depression by week 12. Depression scores in the CM-PST group dropped by 4.1 points more than in the SG-PST group between baseline and week 12 (95% CI=0.99-7.22, p<0.001, Hedges's g=1.08).
CONCLUSIONS
The results suggest that peer-supported SG-PST is a viable, acceptable option for rural older adults with depression as a second-line treatment if access to clinicians is limited.
目的
针对农村老年人群体中抑郁的自我指导和同伴支持治疗可能会解决一些常见的治疗障碍。本试点研究比较了在加利福尼亚州农村地区，同伴支持的自我指导问题解决疗法（SG-PST）与临床管理问题解决疗法（CM-PST）对老年人抑郁的影响。
方法
患有抑郁症的老年人（N=105）接受了临床医生的介绍性 PST 治疗，随后接受了 11 次 CM-PST 治疗（N=85）或 SG-PST 治疗（N=20），有同伴辅导员。
结果
两种干预措施均在第 12 周时使抑郁症状得到了明显改善。与 SG-PST 组相比，CM-PST 组的抑郁评分在基线和第 12 周之间下降了 4.1 分（95%CI=0.99-7.22，p<0.001，Hedges's g=1.08）。
结论
结果表明，如果获得临床医生的机会有限，那么同伴支持的 SG-PST 是农村老年抑郁症患者的一种可行且可接受的二线治疗选择。
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