背景:慢性病和抑郁症密切相关,和抑郁症,如果不及时治疗,会加重身体疾病症状。此外,治疗抑郁症可以改善患者的预后。一般来说,少数群体对抑郁症的治疗较低。
目的:本研究的目的是确定慢性疾病负担与抑郁症治疗之间的关系,以及这种关系在白种人和非白种人到初级保健医生就诊之间是否存在差异。
方法:我们使用2014-2019年全国门诊医疗调查(NAMCS)的数据进行了定量二次数据分析。
方法:患有抑郁症的成年人对初级保健医生的访问(n=3832)。
方法:Logistic回归估计药物治疗的几率,心理健康咨询治疗,任何治疗。
结果:患有3种或更多种慢性疾病的患者接受药物治疗的几率为1.39倍(p值=0.06)。然而,当按种族检查治疗时,1~2例慢性疾病的白种人患者接受心理健康治疗的几率(p值=0.09)是非白种人患者接受心理健康治疗的几率(p值=0.09)是非白种人患者接受任何治疗的几率(p值=0.08)的2.09倍.
结论:尽管在p<0.05水平上不显著,结果表明,与没有慢性疾病的患者相比,患有多种慢性疾病的患者在就诊期间接受抑郁症治疗的几率更大.与非白人患者的就诊相比,白人患者的就诊效果似乎更大。需要进一步的研究来证实这些发现,并确定这种关联如何明显影响少数群体,以及差距背后的原因是什么。这些发现可以帮助医生意识到抑郁症治疗的持续差异,并提供更公平的抑郁症治疗。
BACKGROUND: Chronic disease and depression are closely related, and depression, if left untreated, can worsen physical disease symptoms. Furthermore, treating depression can improve patient outcomes. Generally, treatment for depression is lower in minority groups.
OBJECTIVE: The aim of this study was to determine the relationship between chronic disease burden and depression treatment and whether that relationship differs between white to non-white patient visits to primary care physicians.
METHODS: We conducted a quantitative secondary data analysis using data from 2014-2019 National Ambulatory Medical Care Survey (NAMCS).
METHODS: Visits by adults with depression to primary care physicians (n = 3832).
METHODS: Logistic regressions estimated the odds of medication treatment, mental health counseling treatment, and any treatment.
RESULTS: Visits by patients with 3 or more chronic conditions had 1.39 times the odds of receiving medication treatment (p-value = 0.06). However, when examining treatment by race, visits by white patients with 1-2 chronic conditions had 3.04 times the odds of receiving mental health treatment (p-value = 0.09) compared to visits by non-white patients and 2.09 times the odds of receiving any treatment (p-value = 0.08) compared to visits by non-white patients.
CONCLUSIONS: Although not significant at the p < .05 level, the results suggest that the odds of depression treatment is greater during visits by patients with multiple co-occurring chronic conditions compared to visits by people without chronic conditions. It appears that this effect is larger for visits by white patients compared to visits by non-white patients. Further research is needed to confirm these findings and determine how this association impacts
minorities distinctly and what could be the reason behind the disparity. These findings could help physicians be aware of ongoing disparities in depression treatment and provide more equitable depression treatment.