Depression After Spinal Cord Injury: Comorbidities, Mental Health Service Use, and Adequacy of Treatment
Depression After Spinal Cord Injury: Comorbidities, Mental Health Service Use, and Adequacy of Treatment
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DOI：
10.1016/j.apmr.2010.05.016
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发表时间：
2011-03-01
影响因子：
4.3
通讯作者：
Temkin, Nancy
中科院分区：
文献类型：
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作者：
Fann, Jesse R.;Bombardier, Charles H.;Temkin, Nancy
目的：提供有关脊髓损伤 (SCI) 的抑郁症和非抑郁成人的抑郁率和精神共存疾病、心理健康服务使用情况以及抑郁症治疗充分性的数据。设计：横断面调查，作为改善 SCI 后症状和情绪项目 (PRISMS) 的一部分。环境：社区环境。参与者：患有创伤性 SCI 的社区居民 (N=947)。干预措施：不适用。主要结果测量：患者健康问卷 9 (PHQ-9) 抑郁量表、精神病史调查问卷、康奈尔服务指数（心理健康服务使用）和当前药物使用情况。结果：可能的重性抑郁（PHQ-9 评分 >= 10）的患病率为 23%。其他精神疾病的终生患病率很高，尤其是焦虑症。在抑郁症参与者中，29% 目前正在接受任何抗抑郁药物治疗，11% 正在接受指南水平的抗抑郁药物剂量和持续时间，而 11% 的人在过去 3 个月内接受过任何心理治疗，6% 的人在过去 3 个月内接受过指南水平的心理治疗。血清素能抗抑郁药和个体心理治疗是最常见的治疗类型，并且提供者类型和治疗环境也多种多样。人口统计和临床变量与接受心理健康服务或指南水平的护理无关。结论：本研究的结果表明，SCI 和可能的重度抑郁症患者接受心理健康治疗的比例较低。这些发现对于提高 SCI 患者抑郁症治疗的有效性具有重要意义。
Objective: To provide data for depression rates and psychiatric comorbid conditions, mental health service use, and adequacy of depression treatment in depressed and nondepressed adults with spinal cord injury (SCI).Design: Cross-sectional survey as part of the Project to Improve Symptoms and Mood after SCI (PRISMS).Setting: Community setting.Participants: Community-residing people with traumatic SCI (N=947).Interventions: Not applicable.Main Outcome Measures: Patient Health Questionnaire-9 (PHQ-9) Depression Scale, psychiatric history questionnaire, Cornell Service Index (mental health service use), and current medication use.Results: The prevalence of probable major depression (PHQ-9 score >= 10) was 23%. There was a high lifetime prevalence of other psychiatric conditions, particularly anxiety disorders. In depressed participants, 29% currently were receiving any antidepressant and 11% were receiving guideline-level antidepressant dose and duration, whereas 11% had been receiving any psychotherapy in the past 3 months and 6% had been receiving guideline-level psychotherapy in the past 3 months. Serotonergic antidepressants and individual psychotherapy were the most common types of treatment received, and there was a wide range of provider types and treatment settings. Demographic and clinical variables were not associated with receipt of mental health service or guideline-level care.Conclusions: Findings from this study document the low rate of mental health treatment for persons with SCI and probable major depression. These findings have implications for improving the effectiveness of depression treatment in people with SCI.