PREVENTION OF DEPRESSION WITH PRIMARY-CARE PATIENTS - A RANDOMIZED CONTROLLED TRIAL
PREVENTION OF DEPRESSION WITH PRIMARY-CARE PATIENTS - A RANDOMIZED CONTROLLED TRIAL
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DOI：
10.1007/bf02506936
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发表时间：
1995-04-01
影响因子：
3.1
通讯作者：
MILLER, LS
中科院分区：
文献类型：
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作者：
MUNOZ, RF;YING, YW;MILLER, LS
抑郁症的预防是一个值得关注的重要研究目标。抑郁症状和障碍在初级保健患者中特别常见，对功能和福祉的负面影响与其他主要慢性疾病相当。旧金山弗朗西斯科抑郁症预防研究项目进行了一项随机、对照、预防试验，以证明在公共部门为低收入人群（主要是少数民族）服务的环境中实施此类研究的可行性：150名没有抑郁症或其他严重精神障碍的初级保健患者被随机分配到实验性认知行为干预或对照组。实验干预组报告抑郁水平显著降低。抑郁水平的下降是由消极条件频率的下降介导的。在为期1年的试验中，重性抑郁症新发作次数（发病率）的组间差异没有达到显著性。我们的结论是，在公共部门的初级保健环境中进行抑郁症预防试验是可行的，即使在低收入的少数民族人群中，抑郁症状也可以减少。为了进行随机预防试验，以足够的统计功效检验对发生率的影响，必须确定具有更大迫在眉睫风险的亚组。
The prevention of major depression is an important research goal which deserves increased attention. Depressive symptoms and disorders are particularly common in primary care patients and have a negative impact on functioning and well-being comparable with other major chronic medical conditions. The San Francisco Depression Prevention Research project conducted a randomized, controlled, prevention trial to demonstrate the feasibility of implementing such research in a public sector setting serving low-income, predominantly minority individuals: 150 primary care patients free from depression or other major mental disorders were randomized to an experimental cognitive-behavioral intervention or to a control condition. The experimental intervention group reported a significantly greater reduction in depressive levels. Decline in depressive levels was significantly mediated by decline in the frequency of negative conditions. Group differences in the number of new episodes (incidence) of major depression did not reach significance during the 1-year trial. We conclude that depression prevention trials in public sector primary care settings are feasible, and that depressive symptoms can be reduced even in low-income minority populations. To conduct randomized prevention trials that can test effects on incidence with sufficient statistical power subgroups at greater imminent risk have to be identified.