Iosifescu Dan V, Nierenberg Andrew A, Alpert Jonathan E, Papakostas George I, Perlis Roy H, Sonawalla Shamsah, Fava Maurizio
Depression Clinical and Research Program, Psychiatry Department, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Psychosomatics. 2004 Sep-Oct;45(5):419-25. doi: 10.1176/appi.psy.45.5.419.
The authors examined the impact of comorbid medical illness on the rate of relapse of major depressive disorder during continuation therapy. Subjects (N = 128) with major depressive disorder (according to DSM-III-R criteria) achieved clinical remission (a 17-item Hamilton Depression Rating Scale score < or = 7) after 8 weeks of treatment with fluoxetine and entered the continuation phase of antidepressant treatment. They used the Cumulative Illness Rating Scale to measure the severity of comorbid medical illness. Eight patients (6.3%) relapsed during the 28-week continuation phase. With logistic regression, the total burden and the severity of comorbid medical illness significantly predicted the relapse of major depressive disorder during continuation therapy with fluoxetine. Greater medical comorbidity was also associated with higher increases in self-reported symptoms of depression, anxiety, and anger during the follow-up.
作者研究了共病内科疾病对重度抑郁症维持治疗期间复发率的影响。患有重度抑郁症（根据《精神疾病诊断与统计手册第三版修订本》标准）的受试者（N = 128）在接受氟西汀治疗8周后达到临床缓解（汉密尔顿抑郁量表17项评分≤7），并进入抗抑郁治疗的维持阶段。他们使用累积疾病评定量表来衡量共病内科疾病的严重程度。在28周的维持阶段，有8名患者（6.3%）复发。通过逻辑回归分析，共病内科疾病的总负担和严重程度显著预测了氟西汀维持治疗期间重度抑郁症的复发。更高的内科共病率还与随访期间自我报告的抑郁、焦虑和愤怒症状的更大增加有关。
