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青少年重度抑郁症治疗方案研究:TX-YDSRN注册研究观察结果

Examining Treatment Options in Youth With Major Depressive Disorder: Observations From the TX-YDSRN Registry Study.

作者信息

Ayvaci Emine Rabia, Nandy Karabi, Becker Ryan, Stone Laura, Minhajuddin Abu, Slater Holli, Goodman Lynnel C, Wakefield Sarah M, Storch Eric A, Blader Joseph C, Soutullo Cesar A, Emslie Graham J, Trivedi Madhukar H

机构信息

Center for Depression Research and Clinical Care Peter O'Donnell Jr. Brain Institute and Department of Psychiatry University of Texas Southwestern Medical Center Dallas Texas USA.

Children's Health Children's Medical Center Dallas Texas USA.

出版信息

Psychiatr Res Clin Pract. 2025 Mar 24;7(2):128-138. doi: 10.1176/appi.prcp.20240117. eCollection 2025 Summer.

Abstract

OBJECTIVE

Treatment decisions for depression are a complex process, influenced by factors such as clinical characteristics, socioeconomic factors, and patient/caregiver preferences. This study examines the characteristics of treatment options during the first month of enrollment among depressed youth.

METHODS

Data for 646 depressed youth were extracted from the Texas Youth Depression and Suicide Research Network study. Participants' treatments during the first month were categorized as no treatment (NT), psychotherapy only (THER), pharmacotherapy only (MED), or a combination of psychotherapy and pharmacotherapy (COMB). Sociodemographic and clinical features were compared across these treatment types.

RESULTS

7% were on NT, 5% on THER, 35% on MED, and 53% on COMB. The MED group was more likely to have low income compared to the COMB group. Compared to the MED group, COMB treatment had higher depression severity and suicidality. The NT group showed higher rates of social risk compared to the group with COMB. Treatment groups did not differ significantly in sex or race. When treatment preferences were examined, 40% of youth on MED expressed a preference for COMB treatment.

CONCLUSIONS

Treatment options vary with demographic characteristics, depression severity, suicidality, and high-risk social factors. The finding that youth on MED are more likely to have low income compared to COMB treatment, despite a preference for COMB treatment among many, may suggest a potential barrier to accessing comprehensive treatment options.

RELEVANCE TO CLINICAL PRACTICE

Findings highlight the need to address barriers to combination treatment, which is preferred by youth and caregivers for managing depression.

摘要

目的

抑郁症的治疗决策是一个复杂的过程,受到临床特征、社会经济因素以及患者/照顾者偏好等因素的影响。本研究考察了抑郁青少年在入组第一个月内的治疗选择特征。

方法

从德克萨斯青少年抑郁与自杀研究网络研究中提取了646名抑郁青少年的数据。参与者在第一个月的治疗被分类为未治疗(NT)、仅心理治疗(THER)、仅药物治疗(MED)或心理治疗与药物治疗相结合(COMB)。对这些治疗类型的社会人口统计学和临床特征进行了比较。

结果

7%接受NT治疗,5%接受THER治疗,35%接受MED治疗,53%接受COMB治疗。与COMB组相比,MED组更可能收入较低。与MED组相比,COMB治疗的抑郁严重程度和自杀倾向更高。与COMB组相比,NT组的社会风险率更高。治疗组在性别或种族方面没有显著差异。在考察治疗偏好时,接受MED治疗的青少年中有40%表示更喜欢COMB治疗。

结论

治疗选择因人口统计学特征、抑郁严重程度、自杀倾向和高风险社会因素而异。尽管许多接受MED治疗的青少年更喜欢COMB治疗,但与COMB治疗相比,他们更可能收入较低,这一发现可能表明在获得综合治疗选择方面存在潜在障碍。

与临床实践的相关性

研究结果凸显了解决联合治疗障碍的必要性,联合治疗是青少年和照顾者管理抑郁症所偏爱的方法。

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