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| 电子化精神卫生平台“心情温度计”应用于社区抑郁障碍的诊治探索 |
| 黄乐萍1,黄茹燕1,费玥1,徐韦云1,熊金霞1,吴志国2,陈俊3,方贻儒3,汪作为1,4* |
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(1. 上海市虹口区精神卫生中心心境障碍科, 上海 200083;
2. 上海市杨浦区精神卫生中心, 上海健康医学院精神卫生临床研究中心, 上海 200093;
3. 上海交通大学医学院附属精神卫生中心临床研究中心, 上海 200030;
4. 海军军医大学(第二军医大学)心理系精神医学教研室, 上海 200433
*通信作者) |
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| 摘要: |
| 目的 探讨电子化精神卫生服务平台“心情温度计”（心情温度计App）在社区抑郁障碍识别和诊治管理中的作用。方法 选取上海市虹口区2个社区卫生服务中心，随机抽取全科门诊患者700例，通过心情温度计App在线自主筛查和辅助诊断系统中的患者健康问卷抑郁自评量表（PHQ-9）和简明国际神经精神访谈工具（MINI）对被试进行抑郁障碍的初步诊断、筛查，并在3个月后随访抑郁障碍患者的线下诊治情况。结果 社区全科门诊患者PHQ-9抑郁症状检出率为14.86%（104/700），MINI抑郁障碍检出率为7.86%（55/700）。55例抑郁障碍患者中，单相抑郁46例、双相抑郁8例、恶劣心境1例。46例单相抑郁患者中8例既往已确诊，8例双相抑郁中1例既往诊断抑郁症，临床诊断率为1.29%（9/700），MINI抑郁障碍检出率比临床诊断率提升6.57%。抑郁障碍患者基线诊治率为16.36%（9/55），3个月后随访诊治率增加了10.91%（6/55），诊治率提升至27.27%（15/55）。结论 在社区筛查和诊断评估中，电子化精神卫生平台不仅能提升抑郁障碍的识别率，而且对后续实际临床诊治率也有良性推动作用。今后宜将电子化精神卫生评估整合到初级保健服务中，促进抑郁障碍的早期诊断和有效治疗。 |
| 关键词: 电子化精神卫生 抑郁障碍 识别 治疗率 心情温度计 |
| DOI：10.16781/j.CN31-2187/R.20210817 |
| 投稿时间：2021-08-18修订日期：2022-03-07 |
| 基金项目:国家重点研发计划（2016YFC1307105），上海市医学重点专科建设计划（ZK2019A06），上海市精神心理疾病临床医学研究中心项目（19MC1911100），上海市卫生健康委员会科研课题（202040318），虹口区卫生健康委员会临床重点扶持专科（HKZK2020A11），虹口区卫生和计划生育委员会重点科研课题（虹卫1602-11）. |
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| Application of E-mental health service platform “mood thermometer” for diagnosis and treatment of depression disorder in community setting |
| HUANG Le-ping1,HUANG Ru-yan1,FEI Yue1,XU Wei-yun1,XIONG Jin-xia1,WU Zhi-guo2,CHEN Jun3,FANG Yi-ru3,WANG Zuo-wei1,4* |
(1. Division of Mood Disorders, Mental Health Center of Hongkou District of Shanghai, Shanghai 200083, China;
2. Shanghai Yangpu Mental Health Center;Clinical Research Center in Mental Health, Shanghai University of Medicine & Health Sciences, Shanghai 200093, China;
3. Division of Mood Disorders, Mental Health Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China;
4. Department of Psychiatry, Faculty of Psychology, Naval Medical University (Second Military Medical University), Shanghai 200433, China
*Corresponding author) |
| Abstract: |
| Objective To explore the role of the E-mental health service platform "mood thermometer" in the recognition, diagnosis and treatment of depression disorders in community setting. Methods Mood thermometer application (App) is an online autonomous screening and auxiliary diagnosis system. A total of 700 outpatients from 2 community health service centers in Hongkou District of Shanghai were evaluated with the self-designed questionnaire, patient health questionnaire-9 (PHQ) and the mini-international neuropsychiatric interview (MINI), which had been set in the App for detection of depression disorder. Subsequent offline diagnosis and treatment of the patients were followed up 3 months later. Results The recognition rate of depressive symptoms was 14.86% (104/700) as detected by PHQ-9, and the detection rate of depressive disorder was 7.86% (55/700) as detected by MINI. Among the 55 patients with depression, 46 had unipolar depression, 8 had bipolar depression, and 1 had dysthymia. Of the 46 patients with unipolar depression, 8 were previously diagnosed, and 1 of the 8 patients with bipolar depression was previously diagnosed with depression, with a clinical diagnosis rate of 1.29% (9/700). The detection rate of MINI for depressive disorder was 6.57% higher than the clinical diagnosis rate. The treatment rate of patients with depression disorder was 16.36% (9/55) at baseline and increased by 10.91% (6/55) 3 months later, with the diagnosis and treatment rate increased to 27.27% (15/55). Conclusion The E-mental health platform in the community screening and diagnosis evaluation can not only improve the detection rate of depression disorder, but also promote the subsequent actual clinical diagnosis and treatment rate. E-mental health assessment should be integrated in the primary health care services to promote early diagnosis and effective treatment of depression disorder. |
| Key words: E-mental health depressive disorder recognition treatment rate mood thermometer |
