PCU Manual Depression

8/12/2019 PCU Manual Depression

1/77

:


2/77

3

29 2551

(..)

.

..

(.)

(.)

0 2903 8257-9

:

1 2553

ISBN: 978-974-299-155-5

3 5 .. . .110000 2951 1286 http://www.hsri.or.thhttp://www.hph.moph.go.th

. .. .

.. .


3/77

|

5

..

408/2552 18 2552

..

858/2553 23 2553

..

(.)

..

.., (././.)

(.)

(.)

.

.. 9

(.) (.)

(.)


4/77

7

(.)

(.)

(..) .

..

(good practice)

..

.


5/77

|

11

21

22

1 23

2 45

3 59

81

5 97

6 119

7 125

141

(.)

..


6/77

11

( . .)

...


7/77

12 |

13

1.

2.

3. 5

.

5. (.)

/

.. (ca tchment area)

(home ward)

...

1. ()

1.1


8/77

1 |

15

1.2

1.3

1.4

3

4 -

-

-

-

(.)

2. ( )

2.1


9/77

16 |

17

2.2

- (Home Health Care)

- (Home Ward

Round) Ward

2.3

2.4

2.5

4 .........

1

/

2 (.)


10/77

1 |

19

3

2

.

(.)

1.


11/77

20 |

2. .

- /

- 1667 1323

-

- 1667 1323

-

.


12/77

. / .. .. .

2Q 15

9Q 9Q

8Q

9Q /

8Q

1

9Q

2

8Q

Non MDD MDD 9Q

Mild 9Q =7-12

Csg + Ed

Moderate

9Q = 13-18 Rx + Csg +Ed Severe9Q 19

Csg

Education

9Q


13/77

25

1

(..)

1.

2.

3.

4.

..


14/77

26 |

27

1

..2545 -2549 3.7

5. ..

6.

7.

8.

9.

10.

..

4


15/77


16/77

30 |

31

1

..

2.2

(Home Health Care)

/

.. .

2.3 -

2.

2.5


17/77

32 |

33

1

(.)

2.6

.

..

..

..

..


18/77

3 |

35

1

..

..

..

..

..

..


19/77

36 |

37

1

..

(Training)

...

..

..

... 9

2 .......


20/77

3 |

39

1

(Mentoring)

(Mentee)

Mentee

.. Mentee

.......

Internet

...

.......

....

......

....


21/77

0 |

1

1

(Coaching)

(two way communication)

(Individual Performance)

(Supervision)

..

......

.....

... ()

...

...

....


22/77


23/77

2


24/77

6 |

47

2

4

2020

2 1 4

1 10

100

11

5%

20 3%


25/77

|

9

2

Depressive disorders


26/77

50 |

51

2

1.

2.

3.

( 2-3 .

) 4.

1-2

5.

6.

7. (

)

8.

9.

5 2 ( 1) ( 2)

07.30.......

...


27/77

52 |

53

2

2.8

31-42%

!.


28/77

5 |

55

2

3.2

15-59 800,000

(Major Depressive Disorder) 300,000

(Dysthymia)

Depressive Disorder Remission

Raplace


29/77

56 |

57

2

( )

( )

30-45

3

2-3

1-2

8

6 1

6 1


30/77

5 |

3


31/77

60 |

61

3

...


32/77

62 |

63

3

2545-2549

3.7

..

..

. ..

1.


33/77


34/77

66 |

67

3

1. /

/

..

. 6 2549 - 2552 7 , 4 , 2 7 3 , 2 , 1 2 2549 2552

53 4 1 52 7 2 Best Practice

2

Depression Depressivedisorders Remission Relapse

2Q 9Q,8Q

/

1. ( 6 )2. 3.

9Q, 8Q

9Q 7


35/77

6 |

69

3

..

2.

(

)

3.

..

1.

2.

3.

4.

5.

6.

7.

8.

... .

...

Counseling .....

....

... ...

....


36/77


37/77

73

3

+ve =

. =

.. =

. / . = /

. = 2Q = 2

9Q = 9

8Q = 8

MDD = Major Depressive Disorder

Rx =

Csg = (Counseling)

Ed =

..

1. -

2Q

..

. / .. .. .

2Q 15

9Q 9Q

8Q

9Q /

8Q

1

9Q

2

8Q

Non MDD MDD 9Q

Mild 9Q =7-12

Csg + Ed

Moderate9Q = 13-18 Rx + Csg +

Ed Severe9Q 19

Csg

Education

9Q


38/77

7 |

75

3

2

2.

9Q

3

8Q

3. ..

9Q ..

6

9Q 6

. ..

9Q 1


39/77

77

3

5.

2549

80

2

9


40/77

7 |

79

3

-

..

/./

0=

8(8Q)

.

1-8

=

9-16=

17

=

-

.

1)

2Q

2(2Q)

.

../

./

2)

.

2

(1

2)

-

..

/./


41/77

4


42/77

2 |

83

..

. .

2Q

...........


43/77

|

85

1.

2.

3.

4.

5. 6.

7.

8.

..

..

..

2552 . 15 3 ( ) PHQ 9

7 .


44/77

6 |

87

: 2 (2Q ) :

:/

: (.) () .././.

1.

...

....

2.

2Q 2

2

2

3.

4.

4.1 2

4.2 2 (

1 2)

9Q ()

5. (

)


45/77

|

9

9Q

9Q 2 3

6.

9Q (

9Q 7

)

2Q

1.

2.

3. 2Q

9

4.

5. 9Q (

9Q)

1. 2 :

2. 2 :

2 (2Q)


46/77

90 |

91

9Q () 8Q

: 9 (9Q) :

:

2Q

: .././.

1.

..

.....

9

2.

3. 9Q

4.

9Q 9Q 2

5. 9


47/77

92 |

93

()

6.

7.

7.1

9Q

7.2

2Q

9Q

.....

7.3

7.4 7

8Q

8. >7

..

.

.

9Q

9Q


48/77

9 |

95

2

: 8Q () :

: >7 9Q

: .././.

1.

9Q

/

8Q

2.

/

3.

9Q

4.

0

(

8)

>7

9Q


49/77

5


50/77

9 |

99

5

......

..

(. .)

..

1.

2.

3.

4.

5.

6.


51/77

100 |

101

5

1.

:

: 2Q

: ..

1.

2.

3. 30-45 3

4. / 2Q

2.

:

: 2Q

: () ..

9Q

1.

2.

3.

4. 30 - 45

3

5. EQ (

www.klb.dmh.go.th)

6. / 2Q

..


52/77

102 |

103

5

3.

:

: = 7 - 12 9Q

..1. 8Q2.

3.

4.

5.

. .

DMwithcataract9Qmoderatedepression8Qdepression.....


53/77

10 |

105

5

4.

:

: = 13 - 18 9Q

..1. 8Q2.

3.

4. 30 - 45

5. .

.

6.

5.

:

: 19

9Q

..1. 8Q

2.

3.

4.

5. .

.


54/77


55/77

10 |

109

5

- (personality disorder)

2. 7 9Q 1 8Q

. .

1.

2.

3.

4.

1. (Q = 1 - )

1.1

1.2

2. (Q = 9 - 16 )

2.1

2.2


56/77

110 |

111

5

()

2.3

3. (Q 17 )

3.1

24

3.2

3.3 9Q

13

8

9

0

(8)

(Antidepressant)

..

..

. . .

(Antidepressant)

Nortriptyline Amitriptyline

Fluoxetine

(Antidepressant) 9Q


57/77


58/77

11 |

115

5

1. -

2.

3.

4.

(

)

5. ..

6.

7.

9Q

1. ..

2. /

3. ICD -10

4. 9Q :

9Q

5. Suicidality :

8Q

6. Drug :

(

)

7.

8.

1

9.


59/77

/

(2Q)

.

(

)

9Q..

(..

9Q)

..

7-1

2

9Q

1

3-1

8

9Q

..

1.

./

.

2.

3.

-

-

9Q

-

./.

116 |

117

5

/

19

/

17

8Q

..

1.

.

(..

.

.

)

2.

-

-

9Q8Q

-

3.

..

.

./

.


60/77

6


61/77

120 |

121

6

.....

...

..

(Relapse) 6

22

(Recurrent)

6


62/77

122 |

123

6

1.

( 9Q


63/77

100

20

3040

6050

708090

2551 2552 2553

( 1 )

12 |

-

-

-

7


64/77

126 |

127

7

...

...

...

..


65/77


66/77

130 |

131

7

4.

5.

6.

7.

1.

2.

3.

4.

5.

6.

7.

8.

9.


67/77

132 |

133

7

1.

2.

-

-

-

3.

2

1.

2.

5

1.


68/77

13 |

135

7

2.

3.

-

-

- -

4.


69/77

136 |

137

7

-

-


70/77

13 |

139

7

-

-

-

- 2 - 3

-

-

5.


71/77


72/77

12 | 13

3

(2Q)

1 2 2 2 () : ()

2 2 2 2 () :

/

2

2 (

1 2)

9Q


73/77

1 | 15

2

9 (9Q)


74/77

, , , , . : 2546.

. 2547 ; 12 : 177-188.. ( 1). : ; 2552.

. . . 2542 ;

44 : 38-45 . .: ; 2549.

, , , , , , , . 2 . . 2550 ;52 : 138-148.

. . : ; 2553.

148 |


75/77

2 2 2 ( 1-7 >7 ()

() ) () ()

1 0 1 2 3

2 0 1 2 3

3 0 1 2 3

4 0 1 2 3

5 0 1 2 3

6 0 1 2 3

7 0 1 2 3

8 0 1 2 3

9 0 1 1 3

145


76/77

8 (8Q)

()

1 0 1 ....

2 0 2 ...

3 .... 0 6( ()... ( ).... )...() 0 8

4 0 8

5 0 9

6 0 4

7 / 0 10

8 () 0 4 ()

1()

146 |


77/77

0 1 - 8 9 - 16 17

1 - 7

1 8

Documents

PCU Manual Depression