Mohr D C, Goodkin D E, Likosky W, Gatto N, Baumann K A, Rudick R A
University of California, San Francisco, USA.
Arch Neurol. 1997 May;54(5):531-3. doi: 10.1001/archneur.1997.00550170015009.
To examine the relationship between patient-reported depression and adherence to therapy with interferon beta-1b (IFN beta-1b) and to test the hypothesis that treatment of depression is associated with improved adherence.
Patients with multiple sclerosis were followed up 6 months after initiating therapy with IFN beta-1b.
A university outpatient multiple sclerosis center, an academic group practice, and a health maintenance organization.
Eighty-five patients with clinically evident multiple sclerosis taking IFN beta-1b.
Follow-up questionnaire.
Thirty-five (41%) of the 85 patients reported new or increased depression within 6 months of initiating therapy with IFN beta-1b. Patients experiencing symptoms of depression were more likely to discontinue therapy. Among the patients reporting new or increased depression, 86% who received psychotherapy or antidepressant medication and 38% of the patients who received no therapy for depression continued the IFN beta-1b therapy (P = .003). Although psychotherapy was used as a treatment option more frequently in university and academic group practice-based multiple sclerosis clinics than in the health maintenance organization (P = .02), the treatment adherence patterns were similar across sites.
These findings support previous findings that patients report increased depression after initiating therapy with IFN beta-1b. Although the source of this depression is unclear, these findings suggest that treating patient-reported depression increases adherence to treatment.
研究患者报告的抑郁症与干扰素β-1b（IFNβ-1b）治疗依从性之间的关系，并检验抑郁症治疗与依从性改善相关的假设。
对开始使用IFNβ-1b治疗6个月后的多发性硬化症患者进行随访。
一所大学门诊多发性硬化症中心、一个学术团体诊所和一个健康维护组织。
85例临床确诊为多发性硬化症且正在使用IFNβ-1b治疗的患者。
随访问卷。
85例患者中有35例（41%）报告在开始使用IFNβ-1b治疗的6个月内出现新的或加重的抑郁症。出现抑郁症状的患者更有可能停止治疗。在报告有新的或加重的抑郁症的患者中，接受心理治疗或抗抑郁药物治疗的患者中有86%继续使用IFNβ-1b治疗，未接受抑郁症治疗的患者中有38%继续使用IFNβ-1b治疗（P = 0.003）。虽然在基于大学和学术团体诊所的多发性硬化症患者中，心理治疗作为一种治疗选择的使用频率高于健康维护组织（P = 0.02），但各地点的治疗依从模式相似。
这些发现支持了先前的研究结果，即患者在开始使用IFNβ-1b治疗后报告抑郁症有所增加。虽然这种抑郁症的来源尚不清楚，但这些发现表明，治疗患者报告的抑郁症可提高治疗依从性。
