Oquendo Maria A, Baca-Garcia Enrique, Kartachov Alexei, Khait Vadim, Campbell Carl E, Richards Monique, Sackeim Harold A, Prudic Joan, Mann J John
Silvio O. Conte Centers for the Neuroscience of Mental Disorders for the Study of the Neurobiology of Suicidal Behavior, New York, USA.
J Clin Psychiatry. 2003 Jul;64(7):825-33. doi: 10.4088/jcp.v64n0714.
Major depression is often treated with medications in doses that are too low or too short in duration. We published an early version of the Antidepressant Treatment History Form (ATHF) that rates the adequacy of antidepressant treatment. The updated ATHF presented here includes newer medications and a computer algorithm to automate the evaluation of the adequacy of pharmacotherapy or electroconvulsive therapy for depression.
The computer algorithm was written in MS-DOS Q-BASIC and in Visual Basic 5.0. Treatment data from 47 depressed (Structured Clinical Interview for DSM-III-R) patients were scored by the computer algorithm and assigned a number from 0 to 5 for the adequacy of antidepressant treatment. A psychiatrist blinded to the computer ratings manually rated the treatment using the ATHF.
The computer algorithm, based on an updated version of the ATHF, estimates the adequacy of treatment of unipolar and bipolar depression. Computer algorithm results agreed with those generated by a clinician completing the form manually (kappa = 0.88 to 1.00).
The computer algorithm can be used to analyze large databases and may help reduce the morbidity and mortality associated with major depression by improving the assessment of adequacy of pharmacologic treatments for research and quality assurance purposes. The availability of the updated ATHF on the Internet for downloading allows for modifications according to the user's purposes.
重度抑郁症的治疗通常采用剂量过低或疗程过短的药物。我们发表了早期版本的抗抑郁治疗史表格（ATHF），用于评估抗抑郁治疗的充分性。此处展示的更新版ATHF纳入了更新的药物以及一种计算机算法，以自动评估抑郁症药物治疗或电休克治疗的充分性。
计算机算法用MS-DOS Q-BASIC和Visual Basic 5.0编写。通过计算机算法对47名抑郁症患者（采用DSM-III-R结构化临床访谈）的治疗数据进行评分，并为抗抑郁治疗的充分性赋予0至5的分数。一名对计算机评分不知情的精神科医生使用ATHF对治疗进行人工评分。
基于更新版ATHF的计算机算法可评估单相和双相抑郁症的治疗充分性。计算机算法的结果与临床医生手动填写表格得出的结果一致（kappa系数=0.88至1.00）。
该计算机算法可用于分析大型数据库，并可能通过改善对药物治疗充分性的评估，助力降低与重度抑郁症相关的发病率和死亡率，以用于研究和质量保证目的。互联网上可供下载的更新版ATHF允许根据用户目的进行修改。
