The long-term trajectory of depression among Latinos in primary care and its relationship to depression care disparities.
The long-term trajectory of depression among Latinos in primary care and its relationship to depression care disparities.
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DOI：
10.1016/j.genhosppsych.2010.12.001
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发表时间：
2011-03
影响因子：
7
通讯作者：
Vega WA
中科院分区：
文献类型：
--
作者：
Interian A;Ang A;Gara MA;Rodriguez MA;Vega WA
药物治疗的使用率较低，医患沟通较差以及抑郁症的耻辱感是导致拉丁美洲抑郁症患者心理健康差异的关键因素。目前的研究调查了这些关键变量与拉丁美洲人初级保健中抑郁症的长期轨迹之间的关系。参与者（N=220）是拉丁美洲人提出的初级保健谁筛选抑郁症阳性。重复测量设计用于评估基线、6个月、25个月和30个月的参与者。重复测量包括抑郁症（PHQ-9），自我报告的医患沟通质量，以及与抗抑郁药有关的耻辱。使用生长曲线模型，研究人员对参与者的抑郁症状轨迹进行了为期30个月的检查。自我报告的使用抗抑郁药，医患沟通，抗抑郁药的耻辱作为抑郁症状轨迹的预测因素进行了检查。此外，抑郁症的改善/缓解和复发/复发率进行了检查。在30个月期间，69.4%的参与者经历了改善/缓解。在6个月或25个月改善/缓解的患者中，63.4%的患者在30个月内保持改善/缓解。抑郁症状的长期轨迹显示出与抗抑郁剂污名显著正相关，与使用抗抑郁剂治疗和高质量医患沟通显著负相关。虽然复发/复发很常见，但这项研究中的大多数拉丁美洲人在30个月内抑郁症有所改善。对于许多人来说，有相当长的时间来达到改善/缓解。此外，这些研究结果证实了抗抑郁药使用不足，医患沟通和污名化的拉丁美洲人在初级保健抑郁症的长期结果的重要性。
Lower use of medication treatment, poorer doctor-patient communication, and depression stigma are key contributors to mental healthcare disparities among Latinos with depression. The current study investigated the relationship between these key variables and the long-term trajectory of depression in primary care among Latinos. Participants (N=220) were Latinos presenting to primary care who screened positive for depression. A repeated measures design was used to assess participants at baseline, 6, 25, and 30-months. Repeated measures included depression (PHQ-9), self-reported quality of doctor-patient communication, and stigma pertaining to antidepressants. Using growth curve modeling, participants' depressive symptom trajectories were examined for a 30-month period. Self-reported utilization of antidepressants, doctor-patient communication, and antidepressant stigma were examined as predictors of the depressive symptom trajectory. Also, rates of depression improvement/remission and recurrence/relapse were examined. Improvement/remission was experienced by 69.4% of participants during a 30-month period. Among those who improved/remitted at six or 25 months, 63.4% maintained that improvement/remission by 30-months. The long-term trajectory of depressive symptoms demonstrated a significant positive association with antidepressant stigma and significant negative associations with use of antidepressant treatment and quality doctor-patient communication. While relapse/recurrence is common, most Latinos in this study experienced improvement in depression over 30 month. For many, there is a considerable time to reach improvement/remission. Also, these findings confirm the significance of antidepressant underutilization, doctor-patient communication, and stigma in the long-term outcome of depression among Latinos in primary care.
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DOI：
10.1080/10705519909540118
发表时间：
1999-01-01
影响因子：
6
作者：
Hu, Li-tze;Bentler, Peter M.
通讯作者：
Bentler, Peter M.
影响因子：
3.1
作者：
Curran, PJ;Muthén, BO
通讯作者：
Muthén, BO
影响因子：
3.4
作者：
Miranda, J;Duan, NH;Wells, KB
通讯作者：
Wells, KB
影响因子：
3.8
作者：
Interian, Alejandro;Ang, Alfonso;Vega, William A.
通讯作者：
Vega, William A.
影响因子：
3.3
作者：
Interian, Alejandro;Martinez, Igda;Guarnaccia, Peter J.
通讯作者：
Guarnaccia, Peter J.