二级保健中持续性抑郁症的专家治疗:英国多中心研究的持续效应在24个月和36个月
Neil Nixon1, Boliang Guo2, Catherine Kaylor-Hughes3
1Institute of Mental Health, School of Medicine, University of Nottingham, Nottingham, UK; Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK.
Journal of affective disorders
|October 20, 2023
概括
与标准护理相比,专业抑郁服务 (SDS) 在持续的中度至重度单极抑郁症方面证明了长期的临床益处. 这种协作治疗模式显示,抑郁症评级和功能持续改善,这表明它对未来的心理健康服务的潜力.
科学领域:
- 心理健康研究 心理健康研究
- 临床心理学 临床心理学
- 精神病学是一个精神病学.
背景情况:
- 持久性抑郁症在没有明确的服务框架的情况下,会带来巨大的健康成本.
- 缺乏有效启动抑郁症治疗的长期结果数据.
- 这项研究解决了对持续性抑郁症护理长期有效性的证据的需求.
研究的目的:
- 为了评估专家的长期临床有效性,针对持续中度至重度单极性抑郁症的协作护理模型.
- 为了比较专家抑郁服务 (SDS) 与通常治疗 (TAU) 的结果.
- 提供长期结果数据,以告知持续性抑郁症服务的调试.
主要方法:
- 一个多中心,务实,单盲,并行组随机对照试验 (RCT).
- 在12个月内,SDS协作治疗 (CBT和药物治疗) 与通常治疗 (TAU) 的比较.
- 治疗开始后24个月和36个月的长期随访评估.
主要成果:
- 在24个月后,与TAU相比,SDS在汉密尔顿抑郁评分表 (HDRS17) 评分上呈现出统计学上显著的改善.
- 全球运行评估 (GAF) 评分的非显著改善有利于24个月的SDS.
- 在36个月后,与TAU相比,SDS观察到更高的持续反应和缓解率,尽管消耗.
结论:
- 专家抑郁服务 (SDS) 模型为持续的中度至重度抑郁症提供了持续的长期临床益处.
- 这些发现表明,这种协作护理模式是有效的,可以为未来的专业心理健康服务开发提供信息.
- 长期有效性数据支持对复杂和持久抑郁障碍的专业服务的实施.
相关概念视频
01:30Electroconvulsive Therapy
47
Electroconvulsive therapy (ECT), or shock therapy, remains a critical biomedical intervention for severe, treatment-resistant depression. While its origins can be traced back to Hippocrates' observations that malaria-induced convulsions alleviated mental illness, modern ECT has evolved significantly from its earlier, more primitive applications. First introduced in 1938 by Ugo Cerletti and his colleagues, ECT involves inducing controlled seizures using electrical currents. In its early...
47
01:23Antidepressant Drugs: MAOIs and Other Agents
254
Atypical antidepressants, including bupropion (Wellbutrin), mirtazapine (Remeron), nefazodone (Serzone), trazodone (Desyrel), and vilazodone (Viibryd), offer unique mechanisms of action. Bupropion weakly inhibits dopamine and norepinephrine reuptake, aiding depression treatment and smoking cessation, with a low risk of sexual dysfunction. Mirtazapine enhances serotonin and norepinephrine neurotransmission, leading to sedation, increased appetite, and weight gain. As a result, it helps treat...
254
01:24Treatment Strategies for Psychological Disorders
145
Treatment approaches for psychological disorders fall into three main categories: psychological, biological, and sociocultural. Each approach targets different aspects of mental health, requiring varying levels of education and training.
Psychological therapies focus on modifying emotions, thoughts, and behaviors through talking, interpreting, listening, rewarding, challenging, and modeling. Clinical psychologists, counselors, and social workers commonly practice psychotherapy. Clinical...
Psychological therapies focus on modifying emotions, thoughts, and behaviors through talking, interpreting, listening, rewarding, challenging, and modeling. Clinical psychologists, counselors, and social workers commonly practice psychotherapy. Clinical...
145
01:05Long-term Depression
30.9K
Long-term depression, or LTD, is one of the ways by which synaptic plasticity—changes in the strength of chemical synapses—can occur in the brain. LTD is the process of synaptic weakening that occurs over time between pre and postsynaptic neuronal connections. The synaptic weakening of LTD works in opposition to synaptic strengthening by long-term potentiation (LTP) and together are the main mechanisms that underlie learning and memory.
30.9K
01:27Depressive Disorders: MDD and Dysthymia
138
Depressive disorders are a group of mental health conditions characterized by pervasive feelings of sadness, diminished pleasure in life, and a significant impact on daily functioning. These conditions are most prevalent in individuals during their 30s and affect women at twice the rate of men. Contrary to popular belief, younger individuals are generally more susceptible to these disorders than older adults. Two key types of depressive disorders include Major Depressive Disorder (MDD) and...
138
01:26Psychosis: Goals of Pharmacotherapy
145
Antipsychotic drugs are a crucial treatment method for acute and chronic psychoses, bipolar illness, and behavioral disorders. The selection of these drugs depends on several factors, including the state of the disease, clinical judgment, possible drug interactions, and the patient's sensitivity to adverse effects. In immediate scenarios, such as delirium and dementia, short-term treatment with low doses of high-potency typical or atypical agents can effectively manage symptom exacerbation.
145