检查2461名治疗耐药抑郁症患者的需求,结果和当前治疗途径:混合方法研究研究
Kiranpreet Gill1, Danielle Hett2, Max Carlish1,2
1Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK.
概括
耐治疗性抑郁症 (TRD) 影响了近一半的严重抑郁症患者,导致显著的功能衰退和痛苦. 改善的护理途径和干预措施对于管理这种复杂的疾病至关重要.
科学领域:
- 精神病学是一个精神病学.
- 临床心理学 临床心理学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 大型抑郁症 (MDD) 是一个重大挑战,很大一部分患者患有耐治疗抑郁症 (TRD).
- 在临床上,TRD被定义为对至少两个适当的抗抑郁药治疗试验缺乏反应.
- 这种情况与增加的发病率和功能障碍有关.
研究的目的:
- 调查与TRD相关的临床和服务水平因素.
- 探索英国国家卫生服务 (NHS) 信托机构中TRD患者及其临床医生的实践经验.
- 识别对TRD有效护理的障碍和促进者.
主要方法:
- 采用混合方法方法,将电子健康记录的定量分析与半结构面试的定性主题分析相结合.
- 统计分析包括奇平方测试,单向ANOVA和二进制后勤回归来确定与TRD的关联.
- 半结构面试为患者和临床医生的观点提供了深入的见解.
主要成果:
- 近一半 (48%) 的MDD患者符合TRD标准;36.9%的患者试用了四种或更多类型的抗抑郁药.
- TRD与更高的复发性抑郁症,焦虑障碍,人格障碍,自我伤害和心血管疾病率显著相关.
- 定性数据强调了严重的情绪困扰,治疗挫折,以及与组织/疾病相关的护理障碍,以及增加的经济不活动和功能损失.
结论:
- 耐治疗抑郁症的特点是精神和身体健康问题不断升级和功能衰退.
- 患有TRD的个人在获得和接受有效护理方面面临重大障碍.
- 需要加强护理途径,改进服务结构,以及为TRD开发更有效的生物和心理干预措施.
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