加速抑郁症干预:利用 MCDM-MOORA 技术识别关键心理因素,以便尽早开始治疗。

IF 3.6 3区 医学 Q1 PSYCHIATRY Annals of General Psychiatry Pub Date : 2024-10-09 DOI:10.1186/s12991-024-00518-w
Pratham Majumder, Arkita Pal, D Ramya Dorai, B Gopinathan, Saurav Mallik, Naim Ahmad, Ahmed Said Badawy, Suresh Babu Changalasetty
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引用次数: 0

摘要

背景:全面的社会心理评估非常耗时,通常需要多次治疗才能发现导致抑郁症等精神疾病的心理因素。评估时间的长短取决于患者病情的严重程度以及心理治疗师建立融洽关系的效率。然而,长时间的评估会给患者带来病情恶化的巨大风险:方法:利用多目标优化比值分析法(MOORA)的多标准决策(MCDM)方法,在确定 BDI-II 分析所指定的 21 个因素中导致客户抑郁的关键心理因素方面,全面的心理干预发挥了关键作用:在 254 个样本中,MOORA 方法与传统心理疗法的整合显示,两者的 Jaccard 相似系数为 0.8,最小误差为 7%(脆弱指数 = 0.57),这表明两种方法之间存在显著的一致性,都趋向于类似的解决方案。极端抑郁症患者的治疗次数从 18±2 次减少到 11±2 次,减少了 33%-35%(χ2 = 6.94,P = 0.008)。重度抑郁症患者的治疗次数从 14 ± 2 次减少到 8 ± 1 次,即减少了 34-39%(χ2 = 8.32,P = 0.004)。中度抑郁症患者的治疗次数从 9 ± 1 次减少到 5 ± 1 次,即减少了 37-43%(χ2 = 0.29,P = 0.001)。检测主要心理因素的准确率分别提高到极度抑郁 82.88%、重度抑郁 86.74%、中度抑郁 90.34%:与传统方法相比,MOORA 的实施促进了关键心理干预策略的识别和优先排序,使整个过程明显加快。这种加速大大提高了工作的精确性和有效性。此外,通过对贝克抑郁量表-II 模型进行有序统计和相关分析[皮尔逊(r)= 0.8929 和斯皮尔曼等级(ρ)= 0.7551],确定了关键的脆弱因素。这些发现得到了 EDAS 和 TOPSIS 等其他 MCDM 方案的支持,它们在动态决策环境中表现出高度的稳定性和鲁棒性,在不同心理治疗师调整的情景中保持一致。总之,MCDM(MOORA)与有针对性的心理干预相结合,在提高抑郁、认知、情感和躯体综合症等心理疾病患者的幸福感方面取得了显著的积极成果。
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Accelerating depression intervention: identifying critical psychological factors using MCDM-MOORA technique for early therapy initiation.

Background: A thorough psychosocial assessment is time-consuming, often requiring multiple sessions to uncover the psychological factors contributing to mental illness, such as depression. The duration varies depending on the severity of the patient's condition and how effectively the psychotherapist can establish rapport. However, prolonged assessment periods pose a significant risk of patient deterioration.

Methods: The comprehensive psychosocial intervention, led by the Multi-Criteria Decision-Making (MCDM) approach utilizing the Multi-Objective Optimization by Ratio Analysis (MOORA) method, played a pivotal role in identifying the key psychological factors contributing to the depression of the client among the 21 factors specified by BDI-II analysis.

Results: The integration of the MOORA strategy compared to traditional psychotherapy on 254 samples demonstrates a Jaccard similarity coefficient of 0.8, with a minimum error margin of 7% (vulnerability index = 0.57), indicating a significant agreement between the two approaches, both converging towards a similar solution. For patients with extreme depression, the number of sessions reduced from 18 ± 2 to 11 ± 2, showing a 33-35% reduction (χ2 = 6.94, p = 0.008). Severe depression patients experienced a reduction from 14 ± 2 to 8 ± 1 sessions i.e., 34-39% reduction (χ2 = 8.32, p = 0.004). Moderate depression patients saw sessions drop from 9 ± 1 to 5 ± 1, i.e., 37-43% reduction (χ2 = 0.29, p = 0.001). The accuracy for detecting dominant psychological factors improved to 82.88% for extreme, 86.74% for severe, and 90.34% for moderate depression, respectively.

Conclusion: The implementation of MOORA facilitated the identification and prioritization of key psychosocial intervention strategies, making the process significantly faster compared to traditional methods. This acceleration greatly enhanced the precision and efficacy of the work. Additionally, critical vulnerable factors were identified through ordered statistics and correlation analysis [Pearson (r) = 0.8929 and Spearman's rank (ρ) = 0.7551] on the Beck Depression Inventory-II model. These findings were supported by other MCDM schemes such as EDAS and TOPSIS, demonstrating high stability and robustness in dynamic decision-making environments, maintaining consistency across scenarios adapted by different psychotherapists. Overall, the combined application of MCDM (MOORA) and targeted psychological interventions yielded substantial positive outcomes in enhancing the well-being of individuals with psychological illnesses, such as depression, cognitive, affective, and somatic syndromes.

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来源期刊
CiteScore
6.60
自引率
2.70%
发文量
43
审稿时长
>12 weeks
期刊介绍: Annals of General Psychiatry considers manuscripts on all aspects of psychiatry, including neuroscience and psychological medicine. Both basic and clinical neuroscience contributions are encouraged. Annals of General Psychiatry emphasizes a biopsychosocial approach to illness and health and strongly supports and follows the principles of evidence-based medicine. As an open access journal, Annals of General Psychiatry facilitates the worldwide distribution of high quality psychiatry and mental health research. The journal considers submissions on a wide range of topics including, but not limited to, psychopharmacology, forensic psychiatry, psychotic disorders, psychiatric genetics, and mood and anxiety disorders.
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