Treating depression in predominantly low-income young minority women - A randomized controlled trial
Treating depression in predominantly low-income young minority women - A randomized controlled trial
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DOI：
10.1001/jama.290.1.57
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发表时间：
2003-07-02
影响因子：
120.7
通讯作者：
Belin, T
中科院分区：
文献类型：
--
作者：
Miranda, J;Chung, JY;Belin, T
背景贫困的少数民族妇女比白色妇女经历更大的抑郁症负担，因为她们不太可能得到适当的照顾。对贫困少数民族妇女抑郁症的指导性护理的有效性知之甚少，其中大多数人不寻求care. ObjectiveTo确定干预的影响，以提供基于指导的抑郁症护理相比，转介到社区照顾低收入和少数民族women.Design，Setting，and Participants一项随机对照试验在华盛顿，DC，从1997年3月至2002年5月，在郊区的267名妇女中，目前患有严重抑郁症，参加过县级妇女、婴儿和儿童食品补贴项目和第X条计划生育诊所。从基线到6个月，每月测量一次汉密尔顿抑郁评定量表;工具性角色功能（社会适应量表）和社会功能（简表36项健康调查）在基线和3个月和6个月测量。干预参与者被随机分配到一个抗抑郁药物干预方法：将88例患者随机分为3组，对照组88例（帕罗西汀试验，无效者改用安非他酮），心理干预（8周认知行为治疗）（90例），社区精神卫生服务（89例）。
Context Impoverished minority women experience a higher burden from depression than do white women because they are less likely to receive appropriate care. Little is known about the effectiveness of guideline-based care for depression with impoverished minority women, most of whom do not seek care.Objective To determine the impact of an intervention to deliver guideline-based care for depression compared with referral to community care with low-income and minority women.Design, Setting, and Participants A randomized controlled trial conducted in the Washington, DC, suburban area from March 1997 through May 2002 of 267 women. with current major depression, who attended county-run Women, Infants, and Children food subsidy programs and Title X family planning clinics.Outcomes Hamilton Depression Rating Scale measured monthly from baseline through 6 months; instrumental role functioning (Social Adjustment Scale) and social functioning (Short Form 36-Item Health Survey) measured at baseline and 3 and 6 months.Interventions Participants were randomly assigned to an antidepressant medication intervention (trial of paroxetine switched to buproprion, if lack of response) (n=88), a psychotherapy intervention (8 weeks of manual-guided cognitive behavior therapy) (n=90), or referral to community mental health services (n=89).Results Both the medication intervention (P