当前位置: X-MOL 学术Ann. Behav. Med. › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Sex Moderates Treatment Effects of Integrated Collaborative Care for Comorbid Obesity and Depression: The RAINBOW RCT
Annals of Behavioral Medicine ( IF 4.871 ) Pub Date : 2021-02-22 , DOI: 10.1093/abm/kaaa125
Nan Lv 1 , Lan Xiao 2 , Lisa G Rosas 2, 3 , Elizabeth M Venditti 4 , Joshua M Smyth 5 , Megan A Lewis 6 , Mark B Snowden 7 , Corina R Ronneberg 1 , Leanne M Williams 8 , Ben S Gerber 9 , Olusola A Ajilore 10 , Aashutos S Patel 1 , Jun Ma 1, 11
Affiliation  

Background Sex influences health and related behaviors due to biological and psychosocial/socioeconomic factors. Assessing sex-specific responses to integrated treatment for comorbid obesity and depression could inform intervention targeting. Purpose To test (a) whether sex moderates the effects of integrated collaborative care on weight and depression outcomes through 24 months and (b) whether treatment response at 6 months predicts 12 and 24 month outcomes by sex. Methods Secondary data analyses on weight and depression severity (SCL-20) measured over 24 months among 409 adults with obesity and depression in the Research Aimed at Improving Both Mood and Weight trial. Results Men achieved significantly greater weight reductions in intervention versus usual care than women, whereas women achieved significantly greater percentage reductions in SCL-20 than men at both 12 and 24 months. In logistic models, at 80% specificity for correctly identifying participants not achieving clinically significant long-term outcomes, women who lost <3.0% weight and men who lost <4.1% weight at 6 months had ≥84% probability of not meeting 5% weight loss at 24 months. Similarly, at 80% specificity, women who reduced SCL-20 by <39.5% and men who reduced by <53.0% at 6 months had ≥82% probability of not meeting 50% decrease in SCL-20 at 24 months. Conclusions Sex modified the integrated treatment effects for obesity and depression. Sex-specific responses at 6 months predicted clinically significant weight loss and depression outcomes through 24 months. Based on early responses, interventions may need to be tailored to address sex-specific barriers and facilitators to achieving healthy weight and depression outcomes at later time points. Clinical Trial Registration NCT02246413 (https://clinicaltrials.gov/ct2/show/NCT02246413).

中文翻译:

性别缓和了肥胖和抑郁症的综合协作护理的治疗效果:RAINBOW RCT

背景 由于生物学和心理社会/社会经济因素,性别会影响健康和相关行为。评估对合并肥胖和抑郁症的综合治疗的性别特异性反应可以为干预目标提供信息。目的 测试 (a) 性别是否会调节综合协作护理对 24 个月体重和抑郁结果的影响,以及 (b) 6 个月时的治疗反应是否按性别预测 12 个月和 24 个月的结果。方法 在旨在改善情绪和体重试验的研究中,对 409 名患有肥胖症和抑郁症的成年人在 24 个月内测量的体重和抑郁症严重程度 (SCL-20) 的二次数据分析。结果 与常规护理相比,男性在干预中的体重减轻显着高于女性,而女性在 12 个月和 24 个月时 SCL-20 的降低百分比明显高于男性。在逻辑模型中,在正确识别未实现临床显着长期结果的参与者的特异性为 80% 时,体重减轻 <3.0% 的女性和 6 个月体重减轻 <4.1% 的男性有 ≥84% 的概率不满足 5 24 个月时体重减轻 %。同样,在 80% 的特异性下,SCL-20 在 6 个月时降低 <39.5% 的女性和男性在 24 个月时 SCL-20 降低 <53.0% 的概率≥82%。结论 性别改变了肥胖和抑郁症的综合治疗效果。6 个月时的性别特异性反应预测了 24 个月内具有临床意义的体重减轻和抑郁症结果。根据早期的反应,可能需要量身定制干预措施,以解决特定性别的障碍和促进因素,以在以后的时间点实现健康的体重和抑郁症结果。临床试验注册 NCT02246413 (https://clinicaltrials.gov/ct2/show/NCT02246413)。
更新日期:2021-02-22
down
wechat
bug