治疗主要是低收入的年轻少数民族妇女的抑郁症:一个随机对照试验
Jeanne Miranda1, Joyce Y Chung, Bonnie L Green
1Health Services Research Center, University of California at Los Angeles Neuropsychiatric Institute, CA 90024, USA. mirandaj@ucla.edu
JAMA
|July 3, 2003
概括
基于指南的抑郁症治疗,包括药物治疗和心理治疗,显著改善了低收入少数民族妇女的症状和功能. 与心理治疗和社区推相比,药物干预显示出更广泛和更强大的结果.
科学领域:
- 临床精神病学 临床精神病学
- 医疗保健服务研究 医疗服务研究
- 心理健康干预 心理健康干预
背景情况:
- 贫困的少数民族妇女面临更高的抑郁负担和减少获得护理的机会.
- 对于基于指导方针的抑郁症护理对这一群体的有效性,人们的了解有限.
- 大多数贫困的少数民族妇女不寻求专业的心理健康服务.
研究的目的:
- 评估基于指导方针的抑郁症护理干预措施对低收入和少数民族妇女社区转诊的影响.
- 为了比较药物管理和心理治疗在大型抑郁症的有效性,在一个服务不足的人群中.
主要方法:
- 一项随机对照试验,涉及267名参加公共卫生诊所的大型抑郁症妇女.
- 干预包括抗抑郁药物 (帕洛克/布罗),认知行为疗法 (8周) 或社区心理健康转诊.
- 使用汉密尔顿抑郁症评分表,社会调整表和6个月的SF-36健康调查来衡量结果.
主要成果:
- 与社区转诊相比,药物治疗和心理治疗干预都显著减少了抑郁症状.
- 药物干预改善了工具角色和社会功能;心理治疗改善了社会功能.
- 接受药物治疗的女性在6个月内实现显著的症状减轻的可能性是两倍.
结论:
- 符合指导方针的抑郁症治疗对于种族多样化,贫困的患者是有效的.
- 药物干预表明了功能和症状减轻的更广泛和更强大的改善.
- 与心理治疗相比,药物治疗的治疗时间参与度更高.
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