Zajecka John M
Department of Psychiatry, Rush University Medical Center, Chicago, IL 60612, USA.
J Clin Psychiatry. 2003;64 Suppl 15:7-12.
Over the last several years, the recommended end point in the treatment of depression has become remission. Patients who achieve remission not only enjoy the benefits of decreased disability and improved functioning in work, family, and social situations, they also have a lower risk of disease progression and relapse. Despite the benefits associated with remission, many patients are left with residual symptoms that prevent them from achieving these benefits. Potential obstacles to reaching remission include diagnostic issues, inadequate treatment, lack of adherence to the treatment regimen, satisfaction with partial improvement, and failure to recognize residual symptoms. Strategies for treating to remission include ensuring appropriate diagnosis, setting treatment goals, selecting antidepressants that are more likely to result in remission, providing patient education and adequate treatment, assessing for residual symptoms, and heeding partial response or lack of response by switching or augmenting treatment.
在过去几年中，抑郁症治疗的推荐终点已变为症状缓解。实现症状缓解的患者不仅能受益于残疾程度降低以及在工作、家庭和社交场合中功能改善，他们疾病进展和复发的风险也更低。尽管症状缓解有诸多益处，但许多患者仍有残留症状，这使他们无法获得这些益处。实现症状缓解的潜在障碍包括诊断问题、治疗不足、未坚持治疗方案、对部分改善感到满意以及未识别残留症状。实现症状缓解的治疗策略包括确保正确诊断、设定治疗目标、选择更有可能实现症状缓解的抗抑郁药、提供患者教育和充分治疗、评估残留症状，以及通过调整或增加治疗来关注部分反应或无反应情况。
