抑郁症全病程管理模式效果评价

目的：探讨对出院抑郁症患者采用全病程管理模式的近期效果。方法选择2012年1～12月重庆市精神卫生中心出院的114例抑郁症患者，将其分为管理组（58例）和对照组（56例）。管理组在常规门诊药物治疗基础上结合团体认知行为治疗及电话回访式健康教育的全病程管理；对照组常规门诊药物治疗。对所有患者跟踪随访1年，以汉密尔顿抑郁量表（HAMD-17）评估出院时和出院后12个月的病情变化；以世界卫生组织生活质量测定量表评定患者的生活质量，电话随访跟踪患者服药依从性和复发率。结果管理组患者出院后12个月HAMD评分总分及减分显著优于对照组，差异均有统计学意义（P＜0.05）；且生活质量评分、遵医嘱服药的患者比例优于对照组，但复发率低于对照组，差异均有统计学意义（P＜0.05）。结论对抑郁症患者进行全病程管理能提高服药依从性，预防抑郁症复发，提高患者的生活质量。

Evaluation of the whole course management model in depressive disorder

Objective To explore the short-term efficacy of the whole course management model in discharged de-pressed patients. Methods A total of 114 discharged depression patients in Chonqing Mental Health Center from January De-cember 2012 were assigned to management group（n=58） and control group（n=56）. The management group was added with whole course management model of group cognitive-behavioral therapy and call-back health education on the basis of conventional out-patient drug treatment,while the control group received conventional outpatient drug treatment. After 1 year follow-up,Hamilton′s Depression Scale（HAMD-17） was used to evaluate the disease changes of all patients at discharge and 12 months after discharge;the WHOQOL-BREF was adopted to assess the quality of life ,and the medication compliance and recurrence rate were followed up by telephone. Results The deduction of HAMD-17 scores in management group 12 months after discharge was more obvious-ly than that in the control group with statistically significant difference （P〈0.05）. The quality of life and the ratio of patients follow the doctor′s advice in the management group were higher than those in the control group ,the recurrence rate of the management group was lower than that of the control group,and the differences between the two groups had statistical significance（P〈0.05）. Conclusion The whole course management can improve medication compliance ,prevent recurrence and improve the quality of life for depressed patients.