Treating minority patients with depression and anxiety: what does the evidence tell us?
Treating minority patients with depression and anxiety: what does the evidence tell us?
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DOI：
10.1016/j.genhosppsych.2005.07.002
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发表时间：
2006-01-01
影响因子：
7
通讯作者：
Roy-Byrne, PP
中科院分区：
文献类型：
--
作者：
Schraufnagel, TJ;Wagner, AW;Roy-Byrne, PP
目的：本研究的目的是检查目前关于治疗患有情绪和焦虑症的少数族裔/种族患者的知识状况，强调尽可能基于数据的研究。方法：本文回顾了少数族裔获得护理的机会和质量较差的证据，少数族裔和多数族群之间可能影响护理和结果的生物和文化差异，以及最近单独解决少数族裔和与多数族群相比的治疗反应和结果的研究。结果：适当治疗焦虑和抑郁的少数族裔患者存在许多障碍留下来。少数群体精神卫生保健的利用不足和质量差是由于疾病和治疗信念不佳，影响依从性和结果、耻辱感、临床医生未能与患者接触、患者积极性差以及可能影响药物治疗选择的生物学差异。然而，尽管数量有限，一些研究确实表明，当少数族裔得到适当的治疗时，其结果与白人患者的结果相当。 结论：治疗少数族裔成员的临床医生必须考虑从生物学到文化的不同个人因素，才能取得治疗成功。有限的可用数据确实表明少数患者可以通过现有的干预措施成功治疗。对于研究人员来说，最重要的是增加精心设计的干预研究的数量，以便进行特定于民族/种族的分析。 (c) 2006 Elsevier Inc. 保留所有权利。
Objective: The purpose of this study is to examine the current state of knowledge regarding treating ethnic/racial minority patients with mood and anxiety disorders, emphasizing data-based studies whenever possible.Method: This article reviews the evidence on poorer access and quality of care for minorities, the biological and cultural differences between minority and majority populations that may impact care and Outcomes, and recent studies that address minority treatment response and outcomes both alone and in comparison to majority groups.Results: Numerous impediments to appropriately treating anxious and depressed minority patients remain. Underutilization and poor quality of mental health care in minorities is due to less-than-favorable illness and treatment beliefs that affect adherence and outcome, stigma, clinician failure to engage the patient, poor patient activation and biological differences that may impact phannacotherapy choice. However, though limited in number, some studies do indicate that when appropriate treatment is well-delivered to minorities, results are comparable to those seen among Caucasian patients.Conclusions: The clinician treating members of minority groups must consider differential personal elements, from the biological to the cultural, to achieve treatment success. The limited available data do suggest that minority patients can be successfully treated with available interventions. Of primary importance is for researchers to increase the number of carefully designed intervention studies that allow for ethnic/ racial minority-specific analyses. (c) 2006 Elsevier Inc. All rights reserved.