OUTPATIENT CARE FOR DEPRESSION--AGE/GENDER EFFECTS

这项拟议中的研究涉及个体成为 被确认为患有抑郁症，并沿着这条路前进 从社区到精神卫生保健服务。它的重点是角色 年龄和性别对个体通用和特长使用的影响 门诊精神卫生保健，促使提供者识别患者 抑郁，并影响所提供治疗的性质。它 将通过检查患者的年龄、 性别和抑郁症状的自我报告在在场的情况下相互作用 其他因素，以影响作为进展指标的结果 抑郁症的心理保健途径，如使用普通药物 门诊医疗，被常规初级保健诊断为抑郁症 护理提供者，被转介给专门的精神卫生提供者 抑郁症的护理，并接受专门的心理健康护理 抑郁症。在治疗过程中应考虑患者的特征 分析包括健康状况、社会经济特征和既往 使用模式。患者规律的几个特点 还将研究初级保健提供者，包括年龄、性别、专业、 工作量和可获得性的衡量标准以及对治疗的态度 抑郁的症状。 背景是西北地区的Kaiser Permanente(KPNW)，一个大团体 实践医疗保健组织。财政限制不会限制患者获得 初级保健或提供者对大多数治疗方案的选择。这项研究 专注于门诊护理，并将在很大程度上依赖现有的数据库。 这项研究解决了公认的患病率之间的差异 在人群中的抑郁症及其识别和治疗 初级保健提供者。它的动机是之前的研究发现 提高诊断中年龄/性别差异的可能性 与抑郁症严重程度无关的抑郁症的治疗 症状和治疗需求。它将提供应该提供的信息 在制定改善治疗的策略方面有用 初级保健提供者的抑郁。

The proposed research concerns the, process by which individuals become identified as suffering from depression and make their way along the path from the community to mental health care services. It focuses on the role of age and gender in influencing individuals' use of general and specialty outpatient mental health care, in prompting providers to identify patients as depressed, and in affecting the nature of the treatment provided. It will probe this issue by examining the manner in which patients' age, gender, and self-reports of depressive symptoms interact, in the presence of other factors, to affect outcomes that are indicators of progress along the path to mental health care for depression, such as use of general outpatient medical care, being diagnosed as depressed by a regular primary care provider, being referred to specialty mental health providers for care of depression, and receiving specialty mental health care for depression. Patient characteristics to be taken into account in the analysis include health status, socioeconomic traits, and prior utilization patterns. Some characteristics of the patient's regular primary care provider will also be studied, including age, sex, specialty, measures of workload and accessibility, and attitudes toward the treatment of depression. The setting is Kaiser Permanente, Northwest Region (KPNW), a large group practice HMO. Financial constraints do not limit patients' access to primary care or providers' choice of most treatment options. The study focuses on outpatient care, and will rely largely on existing databases. The study addresses the well-recognized discrepancy between the prevalence of depression in the population and its recognition and treatment by primary care providers. It is motivated by previous research findings that raise the possibility of age/sex differentials in the diagnosis and treatment of depression that are not related to severity of depressive symptoms and need for treatment. It will provide information that should be useful in developing strategies for improving the treatment of depression by primary care providers.