Cheung Amy H, Levitt Anthony J, Szalai John P
Department of Psychiatry, Sunnybrook and Women's College Health Sciences Centre, University of Toronto, Ontario.
Can J Psychiatry. 2003 Dec;48(11):727-33. doi: 10.1177/070674370304801104.
This study examines the relative impact of antidepressant side effects on adolescents with a history of major depression.
We used Q-sort methodology to capture the opinions of adolescents with a history of depression (n = 22), adults with a history of depression (n = 20), healthy adolescents (n = 20), and clinicians (n = 18) on the impact of 40 common antidepressant side effects. We asked subjects to force rank the side effects, judging each side effect on its relative impact on their daily lives. We also examined the impact of these side effects on health status and medication compliance. Primary analyses compared adolescents with depression with the other groups on their mean rankings for each of the 40 side effects. Secondary analyses included paired comparisons for ratings on health status and compliance.
Although all groups ranked syncope and vomiting among the worst 5 side effects, significant differences were found between the groups on other side effects, such as anxiety, sleepiness, and hair loss. Based on the side effect with the most negative impact, adolescents with depression judged their own compliance (mean = 22%) to be higher than predicted by clinicians (mean = 11%). There were no significant differences between the groups on the mean rating of health status.
Adolescents with depression, adults with depression, healthy adolescents, and clinicians agreed on the negative impact of 2 side effects: vomiting and syncope. Q-sort methodology provides valuable insight into the similarities and differences in opinion regarding the potential impact of side effects in patient groups.
本研究探讨抗抑郁药副作用对有重度抑郁病史青少年的相对影响。
我们采用Q分类法，收集了有抑郁病史的青少年（n = 22）、有抑郁病史的成年人（n = 20）、健康青少年（n = 20）以及临床医生（n = 18）对40种常见抗抑郁药副作用影响的看法。我们要求受试者对这些副作用进行强制排序，根据每种副作用对他们日常生活的相对影响进行评判。我们还研究了这些副作用对健康状况和药物依从性的影响。主要分析比较了有抑郁的青少年与其他组在40种副作用各自平均排序上的差异。次要分析包括对健康状况和依从性评分的配对比较。
尽管所有组都将晕厥和呕吐列为最严重的5种副作用，但在其他副作用方面，如焦虑、嗜睡和脱发，各组之间存在显著差异。基于负面影响最大的副作用，有抑郁的青少年认为他们自己的依从性（平均 = 22%）高于临床医生预测的水平（平均 = 11%）。各组在健康状况平均评分上没有显著差异。
有抑郁的青少年、有抑郁的成年人、健康青少年和临床医生在两种副作用的负面影响上达成了一致：呕吐和晕厥。Q分类法为深入了解患者群体对副作用潜在影响的看法异同提供了有价值的见解。
