Pain limits the effectiveness of collaborative care for depression.
Pain limits the effectiveness of collaborative care for depression.
复制标题
疼痛限制了抑郁症协作护理的有效性。
DOI：
10.1097/jgp.0b013e3180325a2d
复制
发表时间：
2007
期刊：
影响因子：
--
通讯作者：
J. Unützer
中科院分区：
文献类型：
--
作者：
S. Thielke;Ming‐Yu Fan;M. Sullivan;J. Unützer
目的
确定基线疼痛对老年人抑郁症协同护理治疗试验中抑郁症结局的影响。
方法
在改善情绪：提供合作治疗试验中对1，801名抑郁老年人进行的二次数据分析，使用两个疼痛干扰变量比较无/低和高基线疼痛的组。主要结局是12个月时抑郁评分降低50%。分别对常规护理组和干预组进行分析，然后检查相互作用。
结果
在常规治疗组中，基线疼痛状态与抑郁结局无显著相关性。在干预组中，更高的疼痛干扰与更差的抑郁反应显著相关：48.9%的无/低疼痛干扰的人获得了抑郁反应，而高疼痛的人则为37.4%（卡方= 12.27，df = 1，p = 0.001）。关节炎疼痛干扰显示出类似的关联（卡方= 4.04，df = 1，p = 0.044）。控制社会人口统计学和基线特征并没有减少这种关联。一个显着的交互作用对抑郁反应之间的疼痛干扰和干预，这表明更高的疼痛差异损害抑郁反应的协作护理相比，通常的护理。
结论
协作护理干预在疼痛较少的老年人中显着更成功。疼痛可能是改善抑郁症的一个重要障碍，关注疼痛可能会产生更好的抑郁症结果。
OBJECTIVE
To ascertain the effects of baseline pain on depression outcomes in a collaborative care treatment trial of depression for older adults.
METHODS
A secondary data analysis of 1,801 depressed older adults in the Improving Mood: Providing Access to Collaborative Treatment trial, comparing groups with no/low and high baseline pain using two pain interference variables. The primary outcome was a 50% reduction in depression score at 12 months. Analyses were performed separately for usual care and intervention groups, then examined for interactions.
RESULTS
In the treatment-as-usual group, there was no significant association of baseline pain status with depression outcomes. In the intervention group, higher pain interference was significantly associated with worse depression response: 48.9% of those with no/low pain interference achieved a depression response, compared with 37.4% of those with high pain (chi2 = 12.27, df = 1, p = 0.001). Arthritis pain interference showed a similar association (chi2 = 4.04, df = 1, p = 0.044). Controlling for sociodemographic and baseline characteristics did not diminish this association. A significant interaction effect on depression response was found between pain interference and the intervention, suggesting that higher pain differentially impairs depression response in collaborative care compared to usual care.
CONCLUSION
A collaborative care intervention was significantly more successful in older adults with less pain. Pain may be an important barrier to improvement of depression and attending to pain might produce better depression outcomes.
DOI：
10.1097/01.jgp.0000194646.65031.3f
发表时间：
2006-05
期刊：
The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry
影响因子：
--
作者：
D. Steffens;M. Snowden;Ming‐Yu Fan;H. Hendrie;W. Katon;J. Unützer
通讯作者：
D. Steffens;M. Snowden;Ming‐Yu Fan;H. Hendrie;W. Katon;J. Unützer
影响因子：
5.3
作者：
Karp, JF;Scott, J;Frank, E
通讯作者：
Frank, E
影响因子：
3.1
作者：
Mossey, JM;Gallagher, RM
通讯作者：
Gallagher, RM