很少有患者同时治疗肥胖和抑郁症。

IF 1 4区 医学 Q3 MEDICINE, GENERAL & INTERNAL
Elizabeth Pfoh, Ning Guo, Michael Rothberg
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引用次数: 0

摘要

目的:了解抑郁症和肥胖症合并患者的治疗流行病学,提高护理质量。该研究的目的是确定如何治疗肥胖和新诊断的抑郁症患者,以及治疗是否与体重指数变化有关。方法:本队列研究纳入了2015年至2020年间在大型综合卫生系统进行过2次以上初级保健就诊的肥胖和新诊断的抑郁症成年人。在确诊抑郁症后的45天内进行治疗,包括抗肥胖药物治疗和团体或个人体重管理就诊(如减肥药物);抗抑郁药处方;或者去看心理学家、社会工作者或精神科医生。患者分为治疗组:无治疗组、仅治疗抑郁组、仅治疗体重组或两者兼而有之。使用广义结构方程模型确定治疗组与6个月和12个月时体重指数变化之间的关系,将人口统计学和健康特征作为固定变量,将临床医生标识符作为随机变量。结果:在13729名成年人中,43%接受了抑郁症治疗,3%接受了体重管理治疗,4%两者都接受了。接受体重管理治疗的个体仅在6个月(β = -1.0 kg/m2)和12个月(β = -1.07 kg/m2)时比未接受治疗的个体体重减轻更多。同时接受两种治疗的个体比单独接受抑郁症治疗的个体体重减轻更多(6个月:β = -1.07 kg/m2;12个月:β = -1.21 kg/m2),与单独接受体重管理治疗的患者相比,平均变化相似(P < 0.05)。结论:在新诊断的抑郁症患者中,有机会增加对肥胖的治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Few Patients Are Treated for Both Obesity and Depression.

Objectives: Understanding the epidemiology of treatment for patients with co-occurring depression and obesity can inform care quality. The objective of the study was to identify how patients with obesity and newly diagnosed depression are treated and whether treatment is associated with body mass index change.

Methods: This cohort study included adults with obesity and newly diagnosed depression who had ≥2 primary care visits between 2015 and 2020 at a large integrated health system. Treatment within 45 days of a depression diagnosis was identified, including antiobesity medication and group or individual weight management visits (eg, bariatric medicine); antidepressant prescriptions; or visits with a psychologist, social worker, or psychiatrist. Patients were grouped into treatment groups: none, depression only, weight management only, or both. Generalized structural equation models were used to identify the association between treatment group and body mass index change at 6 and 12 months, accounting for demographic and health characteristics as fixed variables and clinician identifier as a random variable.

Results: Of the 13,729 adults, 43% received depression treatment, 3% received weight management treatment, and 4% received both. Individuals who received weight management treatment only lost more weight at 6 months (β = -1.0 kg/m2) and 12 months (β = -1.07 kg/m2) than individuals with no treatment. Individuals who had both treatments lost more weight than individuals with depression treatment alone (6 months: β = -1.07 kg/m2; 12 months: β = -1.21 kg/m2) and underwent a similar average change than those who received weight management treatment alone (P > 0.05).

Conclusions: There is an opportunity to increase treatment for obesity among patients with newly diagnosed depression.

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来源期刊
Southern Medical Journal
Southern Medical Journal 医学-医学:内科
CiteScore
1.40
自引率
9.10%
发文量
222
审稿时长
4-8 weeks
期刊介绍: As the official journal of the Birmingham, Alabama-based Southern Medical Association (SMA), the Southern Medical Journal (SMJ) has for more than 100 years provided the latest clinical information in areas that affect patients'' daily lives. Now delivered to individuals exclusively online, the SMJ has a multidisciplinary focus that covers a broad range of topics relevant to physicians and other healthcare specialists in all relevant aspects of the profession, including medicine and medical specialties, surgery and surgery specialties; child and maternal health; mental health; emergency and disaster medicine; public health and environmental medicine; bioethics and medical education; and quality health care, patient safety, and best practices. Each month, articles span the spectrum of medical topics, providing timely, up-to-the-minute information for both primary care physicians and specialists. Contributors include leaders in the healthcare field from across the country and around the world. The SMJ enables physicians to provide the best possible care to patients in this age of rapidly changing modern medicine.
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