Changing the course of comorbid eating disorders and depression: what is the role of public health interventions in targeting shared risk factors?
Changing the course of comorbid eating disorders and depression: what is the role of public health interventions in targeting shared risk factors?
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DOI：
10.1186/2050-2974-2-15
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发表时间：
2014
影响因子：
4.1
通讯作者：
Stewart T
中科院分区：
文献类型：
--
作者：
Becker CB;Plasencia M;Kilpela LS;Briggs M;Stewart T
公共卫生在改善全球健康方面有着富有成效的历史，因为它注重使用有效和可扩展的干预措施覆盖大量人口。然而，循证科学与精神疾病领域社区/公共卫生干预措施的实施之间的结合仍然不发达。研究表明，重度抑郁症是饮食失调症（EDs）最常见的合并症。因此，确定共同影响抑郁症和ed的公共卫生战略，包括共同的风险因素，有可能显著影响心理健康痛苦。本文的主要目的是检查和讨论这些公共卫生方法，并探索从公共卫生工作中获得的线索，以告知研究和临床实践的未来方向。由于对所有针对EDs和抑郁症的公共卫生举措的全面回顾超出了本文的范围，本文回顾了一系列大规模和/或得到实证支持的项目/方法。特别是，旨在减少与ED和抑郁相关的可变风险因素的公共卫生相关干预措施，以及旨在减少ED和抑郁症状持续测量的干预措施。迄今为止，尽管在改变ED和抑郁症的危险因素方面取得了重大进展，但该领域仍然缺乏适当设计和/或充分支持的公共卫生研究来评估ED/抑郁症的真正预防效果。此外，尽管一些项目显示出希望，但许多广泛传播的方法缺乏经验支持，这引起了人们对有限资源浪费可能性的担忧。总之，尽管预防和基于公共卫生的方法相结合在试图改变与急症和/或抑郁症相关的风险因素和症状方面似乎具有优点，但还需要进一步的研究来调查这种努力的大规模传播工作的范围和有效性。
Public health has a productive history of improving global health due to its focus on reaching large populations using effective and scalable interventions. Yet, the marriage between evidence-based science and the implementation of community/public health interventions within mental illness remains underdeveloped. Research suggests that major depression is the most commonly cited comorbidity for eating disorders (EDs). Thus, identification of public health strategies that jointly impact depression and EDs, including shared risk factors, has the potential to significantly impact mental health suffering. The primary aim of this paper is to examine and discuss such public health approaches as well as explore cues taken from public health efforts to inform future directions in research and clinical practice. As a comprehensive review of all public health initiatives that address EDs and depression is beyond the scope of this paper, this paper reviews a series of programs/approaches that either are of large scale and/or have received empirical support. In particular, public health related interventions that aim to reduce variable risk factors associated with EDs and depression, as well as interventions that aim to reduce continuous measures of ED and depression symptoms are reviewed. To date, despite significant progress in modifying risk factors for EDs and depression, the field still lacks a public health study that has been appropriately designed and/or adequately powered to assess true ED/depression prevention effects. Further, although several programs show promise, many widely disseminated approaches lack empirical support, raising concerns about the potential for waste of limited resources. In summary, although the combination of prevention and public health based approaches appear to have merit when trying to move the needle on risk factors and symptoms associated with EDs and/or depression, further research is needed to investigate the reach and effectiveness of large scale dissemination efforts of such endeavors.