Assessing patient beliefs in a clinical trial of Hypericum perforatum in major depression
Assessing patient beliefs in a clinical trial of Hypericum perforatum in major depression
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DOI：
10.1002/da.20036
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发表时间：
2004-01-01
影响因子：
7.4
通讯作者：
Gadde, KM
中科院分区：
文献类型：
--
作者：
Bann, CM;Parker, CB;Gadde, KM
对于患有严重抑郁症的患者的信念，以及他们的疾病和有效治疗的原因，我们知之甚少。本研究介绍了一种新的工具来捕捉这些信念，抑郁症的解释模型（EMD）问卷，并探讨了患者参与替代医学，贯叶连翘的临床试验的信念。虽然EMD最初被概念化为具有与疾病模型和治疗方法有关的五个因素，但数据表明，患者的信念与内部和外部控制点有关的两个因素一致。在EMD控制点分量表中的任何一个上的坚定信念与更严重的抑郁症相关。更重要的是，在8周的观察期内，对外部控制源分量表的强烈信念与较少的改善相关。这些结果支持了患者的信念在抑郁症康复中的作用，并表明那些认为抑郁症的原因超出其控制范围的患者不太可能随着时间的推移而改善。值得注意的是，在这项研究中，信念并没有介导治疗对抑郁症的影响，这可能是因为患者对他们的治疗条件不知情。未来的研究应该探讨当患者意识到他们正在接受的治疗时，患者的信念是否会产生更大的影响，并且可以确定这种治疗是否与他们的信念一致。(C)2004 Wiley-Liss，Inc.
Little is known about the beliefs of patients suffering from major depression as to the causes of their illness and effective treatments. This study introduces a new instrument for capturing these beliefs, the Explanatory Model for Depression (EMD) Questionnaire, and explores the beliefs of patients participating in a clinical trial of an alternative medicine, Hypericum perforatum. Although the EMD was originally conceptualized as having five factors pertaining to models of the illness and treatment approaches, the data suggest that patient beliefs are aligned on two factors pertaining to internal and external locus of control. Strong beliefs on either of the EMD locus of control subscales are associated with more severe depression. More importantly, strong beliefs on the external locus of control subscale are associated with less improvement over the 8-week period of observation. These results support the role of patients' beliefs in their recovery from depression and suggest that patients who believe the causes of their depression are outside of their control are less likely to improve over time. It is important to note that beliefs did not mediate the effect of treatment on depression in this study, perhaps because patients were blinded to their treatment condition. Future studies should explore whether patient beliefs have an even greater impact when patients are aware of the treatment they are receiving and can determine whether that treatment is consistent with their beliefs. (C) 2004 Wiley-Liss, Inc.