Factors associated with symptomatic improvement and recovery from major depression in primary care patients
Factors associated with symptomatic improvement and recovery from major depression in primary care patients
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DOI：
10.1016/s0163-8343(00)00086-4
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发表时间：
2000-07-01
影响因子：
7
通讯作者：
Prigerson, HG
中科院分区：
文献类型：
--
作者：
Brown, C;Schulberg, HC;Prigerson, HG
本文介绍了一个事后分析的临床和心理社会因素和信念与治疗结果相关的抑郁症的初级保健患者（N=181）的样本随机分配到一个标准化的治疗或医生的常用洞穴（UC）的健康。发现不同的因素可预测治疗模式的临床结局[UC sis.人际心理治疗（IPT）或去甲替林（NT）]和评价的结果类型（即，8个月时出现抑郁症状或8个月时症状和功能恢复）。还描述了与治疗特定结局相关的因素。与先前的研究一致，8个月时较低的抑郁症状严重程度与较高的基线功能、最小的医学共病、种族和标准化的药理学或心理治疗相关。此外，治疗方式和健康控制点之间的相互作用表明，个人感知更多的自我控制他们的健康和谁接受了标准化的治疗经历了更大的抑郁症状减少在8个月。与抑郁发作症状和功能恢复相关的因素也进行了研究。接受标准化治疗（IPT或NT）的患者对自己的健康有更好的控制，并且没有终身广泛性焦虑症或恐慌症的患者比接受常规治疗的患者更有可能在第8个月康复。虽然临床严重程度和治疗充分性在抑郁发作的症状改善和恢复中起着重要作用，但其他关键因素，如健康信念和非抑郁性精神病理学也会影响恢复。(C)2000 Elsevier Science Inc.
This article describes a post-hoc analysis of clinical and psychosocial factors and beliefs about health associated with treatment outcome in a sample of depressed primary care patients (N=181) randomly assigned to a standardized treatment or physician's usual cave (UC). Different factors were found to predict clinical outcomes for treatment modalily [UC sis. interpersonal psychotherapy (IPT) or nortriptyline (NT)] and the type of outcome evaluated (i.e., depressive symptoms at 8 months or symptomatic and functional recovery at 8 months). Factors associated with treatment-specific outcomes are also described. Consistent with prior studies, lower depressive symptom severity at 8 months reins associated with higher baseline functioning, minimal medical co-morbidity, race, and standardized pharmacologic or psychotherapeutic treatment. Additionally, an interaction between treatment modality and health locus of control indicated that individuals perceiving more self-control of their health and who received a standardized treatment experienced greater depressive symptom reduction at 8 months. Factors associated with symptomatic and functional recovery from the depressive episode were also examined. Patients who received a standardized treatment (IPT or NT) perceived greater control of their health and lacked a lifetime generalized anxiety disorder or panic disorder mere more likely to recover by month 8 than those who received usual care. While clinical severity and treatment adequacy play an important role in both symptomatic improvement and foil recovery from a depressive episode, other key factors such as health beliefs and non-depressive psychopathology also influence recovery. (C) 2000 Elsevier Science Inc.