抑郁症整体管理模式近期效果评价

目的评价整体管理模式对慢性抑郁症患者的近期效果。方法非急性发作期且汉密尔顿抑郁量表（HAMD-17）≥3分的门诊抑郁症患者开放式进入管理组（n=30）和对照组（n=30）。管理组患者在常规门诊治疗基础上接受团体心理干预、自助团体和自我管理的整体管理;对照组继续门诊常规治疗。主要结局评估HAMD-17评分从基线至终点（第6个月末）的变化;次要结局评估包括临床痊愈率、复发率和社会功能缺陷筛选表（SDSS）评分变化。结果协方差分析（ANCOVA）显示管理组与对照组之间基线至终点HAMD-17和SDSS的评分变化差异均有统计学意义（F=46.80,P=0.00;F=49.29,P=0.00）;但F isher s精确检验显示,两组临床痊愈率和复发率比较,差异均无统计学意义（P〉0.05）。结论整体管理模式可能改善慢性抑郁症患者的残留症状和社会功能。

Efficacy of integrated-model management on chronic depression

Objective To evaluate the short-term efficacy of integrated-model management on chronic depression. Methods Outpatients with depression and Hamilton Rating Scale for Depression-17 (HAMD-17)≥3 and without acute episode openly entered management group (n=30) and control group (n=30). Patients in management group received regular clinical care, group therapy intervention, self-help group and self-management, while those in control group only received regular clinical care. The primary outcomes was changes of HAMD-17 scores from baseline to endpoint (the end of the sixth month), and the secondary outcomes included remission rate, recurrence rate and changes of Social Disability Screening Schedule (SDSS) scores from baseline to endpoint. Results Analysis of covariance (ANCOVA) revealed that there were significant differences in the changes of HAMD-17 scores and SDSS scores from baseline to endpoint between management group and control group (F=46.80, P=0.00; F=49.29, P=0.00). However, Fisher's exact test indicated that there was no significant difference in the rates of remission and recurrence between management group and control group (P>0.05). Conclusion The integrated-model management may significantly relieve residual symptoms and improve social function of patients with chronic depression.