改善海湾国家重度抑郁症患者的心理健康状况:电子辅助工具在监测残留症状中的作用综述

Improving Mental Health Outcomes in Patients with Major Depressive Disorder in the Gulf States: A Review of the Role of Electronic Enablers in Monitoring Residual Symptoms.

作者信息

Ahmed Nahida Nayaz, Reagu Shuja, Alkhoori Samia, Cherchali Amina, Purushottamahanti Pradeep, Siddiqui Urooj

机构信息

SEHA Mental Health & Wellbeing Services, College of Medicine and Health Sciences of the United Arab Emirates University, Abu Dhabi, United Arab Emirates.

Weill Cornell Medicine, Doha, Qatar; Hamad Medical Corporation, Doha, Qatar.

出版信息

J Multidiscip Healthc. 2024 Jul 11;17:3341-3354. doi: 10.2147/JMDH.S475078. eCollection 2024.

Abstract

Up to 75% of individuals with major depressive disorder (MDD) may have residual symptoms such as amotivation or anhedonia, which prevent full functional recovery and are associated with relapse. Globally and in the Gulf region, primary care physicians (PCPs) have an important role in alleviating stigma and in identifying and monitoring the residual symptoms of depression, as PCPs are the preliminary interface between patients and specialists in the collaborative care model. Therefore, mental healthcare upskilling programmes for PCPs are needed, as are basic instruments to evaluate residual symptoms swiftly and accurately in primary care. Currently, few if any electronic enablers have been designed to specifically monitor residual symptoms in patients with MDD. The objectives of this review are to highlight how accurate evaluation of residual symptoms with an easy-to-use electronic enabler in primary care may improve functional recovery and overall mental health outcomes, and how such an enabler may guide pharmacotherapy selection and positively impact the patient journey. Here, we show the potential advantages of electronic enablers in primary care, which include the possibility for a deeper "dive" into the patient journey and facilitation of treatment optimisation. At the policy and practice levels, electronic enablers endorsed by government agencies and local psychiatric associations may receive greater PCP attention and backing, improve patient involvement in shared clinical decision-making, and help to reduce the general stigma around mental health disorders. In the Gulf region, an easy-to-use electronic enabler in primary care, incorporating aspects of the Hamilton Depression Rating Scale to monitor amotivation, and aspects of the Montgomery-Åsberg Depression Rating Scale to monitor anhedonia, could markedly improve the patient journey from residual symptoms through to full functional recovery in individuals with MDD.

摘要

高达75%的重度抑郁症(MDD)患者可能有残留症状,如缺乏动机或快感缺失,这些症状会阻碍功能的完全恢复,并与复发相关。在全球范围内以及海湾地区,初级保健医生(PCP)在减轻耻辱感以及识别和监测抑郁症残留症状方面发挥着重要作用,因为在协作护理模式中,初级保健医生是患者与专科医生之间的初步接口。因此,需要为初级保健医生开展精神卫生保健技能提升项目,同时也需要在初级保健中能够快速、准确评估残留症状的基本工具。目前,几乎没有专门设计用于监测MDD患者残留症状的电子工具。本综述的目的是强调在初级保健中使用易于使用的电子工具准确评估残留症状如何改善功能恢复和整体心理健康结果,以及这样的工具如何指导药物治疗选择并对患者就医过程产生积极影响。在此,我们展示了电子工具在初级保健中的潜在优势,包括更深入“探究”患者就医过程以及促进治疗优化的可能性。在政策和实践层面,得到政府机构和当地精神病学协会认可的电子工具可能会得到初级保健医生更多的关注和支持,提高患者参与共同临床决策的程度,并有助于减少围绕精神疾病的普遍耻辱感。在海湾地区,一种易于使用的初级保健电子工具,融合汉密尔顿抑郁量表中监测缺乏动机的部分以及蒙哥马利-Åsberg抑郁量表中监测快感缺失的部分,可以显著改善MDD患者从残留症状到功能完全恢复的就医过程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/20bd/11247372/adc1f73c792b/JMDH-17-3341-g0001.jpg

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