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The Reach of Depression Screening Preceding Treatment: Are There Patterns of Patients Self-Selection?

机译:抑郁症筛查之前的治疗方法:患者是否有自我选择的模式?

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摘要

This study evaluated the reach of depression screening followed by treatment programs for subsyndromal depression and explored demographic and clinical characteristics of patients who were reached versus those who were not. A two-item Patient Health Questionnaire-Depression was sent to 4196 type 2 diabetic patients. Positively screened patients were interviewed to assess the severity of depression, and those with subclinical symptoms were invited to treatment groups. The reach of screening procedure was evaluated by the total response rate, proportion of positive depression screenings, and proportion of eligible patients entering treatment programs. Predictors of responsiveness to screening and of participation in treatment were determined using logistic regression. Of the 34% of patients who returned the questionnaire (n = 1442), 40% reported depressive symptoms and a need for professional help (n = 581). Age (OR = 1.06, 95% CI = 1.05–1.08), BMI (OR = 1.02, 95% CI = 1.00–1.04), HbA1C (OR = .92, 95% CI = .86–.99), and LDL-cholesterol (OR = .90, 95% CI = .81–1.00) correlated with response to screening. Willingness to accept treatment was predicted by professional status (OR = 3.24, 95% CI = 1.53–6.87), education (OR = 1.21, 95% CI = 1.05–1.38), and BMI (OR = .91, 95% CI = .85–.98). Older patients with better diabetes control were more likely to be reached by postal screening for depressive symptoms. Professionally inactive, better-educated persons and those with lower BMI were more likely to participate in the intervention for subsyndromal depression.
机译:这项研究评估了抑郁症筛查的覆盖范围,然后评估了亚综合症抑郁症的治疗方案,并探讨了达到和未达到的患者的人口统计学和临床​​特征。向4196名2型糖尿病患者发送了一项两项抑郁症患者健康问卷。对接受过正面筛查的患者进行访谈以评估抑郁症的严重程度,并将具有亚临床症状的患者邀请到治疗组。通过总缓解率,阳性抑郁症筛查的比例以及进入治疗计划的合格患者的比例来评估筛查程序的覆盖范围。使用logistic回归确定对筛查的反应性和参与治疗的预测指标。在返回问卷的34%的患者中(n = 1442),有40%的患者报告有抑郁症状并需要专业帮助(n = 581)。年龄(OR = 1.06,95%CI = 1.05–1.08),BMI(OR = 1.02,95%CI = 1.00–1.04),HbA1C(OR = .92,95%CI = .86–.99)和LDL -胆固醇(OR = .90,95%CI = .81–1.00)与筛查反应相关。专业程度(OR = 3.24,95%CI = 1.53-6.87),教育程度(OR = 1.21,95%CI = 1.05-1.38)和BMI(OR = .91,95%CI = .85–.98)。通过抑郁症症状的邮政筛查更可能达到控制糖尿病的老年患者。缺乏职业素养,受过良好教育的人和BMI较低的人更有可能参与针对亚综合征的抑郁症的干预。

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