治疗比疾病本身更糟糕吗?:关键利益相关者对使用精神病学电刺激干预治疗难治性抑郁症的看法。

IF 2.6 4区 哲学 Q1 ETHICS
Neuroethics Pub Date : 2025-01-01 Epub Date: 2024-10-16 DOI:10.1007/s12152-024-09573-2
Laura Y Cabrera, Robyn Bluhm, Aaron M McCright, Eric D Achtyes
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引用次数: 0

摘要

精神病学电刺激干预(PEIs)使用电或磁刺激来治疗精神疾病。对于抑郁症治疗,PEIs包括已批准的治疗方式,如电痉挛治疗(ECT)和重复经颅磁刺激(rTMS),以及实验性神经技术,如深部脑刺激(DBS)和适应性脑植入(ABIs)。我们介绍了一项基于调查的实验结果,在该实验中,四个相关利益相关者群体(精神科医生、抑郁症患者、抑郁症成人护理人员和公众)的成员评估了四种PEIs (ECT、rTMS、DBS或ABIs)中的一种治疗是否比治疗难治性抑郁症(TRD)更好或更差,然后为他们的评估提供了叙述解释。总体而言,许多叙事主题的流行程度在利益相关者群体中存在很大差异——精神科医生通常会提供与非临床医生不同的评估理由——但PEI模式的差异要小得多。绝大多数参与者认为他们的PEI比与TRD一起生活更好,他们的理由是对治疗的积极看法和对TRD的消极看法的混合。少数认为指定PEI比患有TRD更糟糕的参与者倾向于表达对其的负面影响,并强调其风险,负面副作用,以及在较小程度上强调其侵袭性。这些叙述性解释的丰富性使我们能够将其置于背景中,并为最近基于调查的PEIs研究中看到的关键模式增加深度。补充资料:在线版本提供补充资料,网址为10.1007/s12152-024-09573-2。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Is the Treatment Worse than the Disease?: Key Stakeholders' Views about the Use of Psychiatric Electroceutical Interventions for Treatment-Resistant Depression.

Psychiatric electroceutical interventions (PEIs) use electrical or magnetic stimulation to treat psychiatric conditions. For depression therapy, PEIs include both approved treatment modalities, such as electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS), and experimental neurotechnologies, such as deep brain stimulation (DBS) and adaptive brain implants (ABIs). We present results from a survey-based experiment in which members of four relevant stakeholder groups (psychiatrists, patients with depression, caregivers of adults with depression, and the general public) assessed whether treatment with one of four PEIs (ECT, rTMS, DBS, or ABIs) was better or worse than living with treatment-resistant depression (TRD) and then provided a narrative explanation for their assessment. Overall, the prevalence of many narrative themes differed substantially by stakeholder group-with psychiatrists typically offering different reasons for their assessment than non-clinicians-but much less so by PEI modality. A large majority of all participants viewed their assigned PEI as better than living with TRD, with their reasons being a mix of positive views about the treatment and negative views about TRD. The minority of all participants who viewed their assigned PEI as worse than living with TRD tended to express negative affect toward it as well as emphasize its riskiness, negative side effects, and, to a lesser extent, its invasiveness. The richness of these narrative explanations enabled us to put in context and add depth to key patterns seen in recent survey-based research on PEIs.

Supplementary information: The online version contains supplementary material available at 10.1007/s12152-024-09573-2.

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来源期刊
Neuroethics
Neuroethics MEDICAL ETHICS-
CiteScore
5.50
自引率
7.10%
发文量
31
审稿时长
>12 weeks
期刊介绍: Neuroethics is an international, peer-reviewed journal dedicated to academic articles on the ethical, legal, political, social and philosophical questions provoked by research in the contemporary sciences of the mind and brain; especially, but not only, neuroscience, psychiatry and psychology. The journal publishes articles on questions raised by the sciences of the brain and mind, and on the ways in which the sciences of the brain and mind illuminate longstanding debates in ethics and philosophy.
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