Cassano Paolo, Soares Claudio N, Cusin Cristina, Mascarini Alessandra, Cohen Lee S, Fava Maurizio
The Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA 02114, USA.
Psychother Psychosom. 2005;74(6):362-5. doi: 10.1159/000087783.
We assessed the impact of menopausal status on treatment response and well-being in a cohort of outpatient women with major depressive disorder (DSM-III-R criteria), who received treatment with fluoxetine (20 mg/day for 8 weeks).
Menopausal status was defined based on age, presence of menstrual irregularity or amenorrhea and vasomotor symptoms. Remission and response of depression were defined as a 17-item Hamilton Depression Rating Scale (HAM-D-17) score <or=7 and a HAM-D-17 decrease >or=50%, respectively. Well-being was assessed by self-rating with the Symptom Questionnaire. Remitters were followed up for 28 additional weeks.
No differences in rates of response and remission as well as in levels of well-being were observed among pre- (n = 121), peri- (n = 28) and postmenopausal (n = 35) women at the endpoint of the acute phase, even after adjustment for baseline depression severity. Residual symptoms, however, were significantly more common in postmenopausal women, except for the continuation phase endpoint. Differences in residual symptoms during the acute phase subsided after adjustment for baseline depression severity.
Overall, menopausal status did not significantly affect the response to fluoxetine treatment and the degree of posttreatment well-being among major depressive disorder patients.
我们评估了绝经状态对一组患有重度抑郁症（符合《精神疾病诊断与统计手册》第三版修订版标准）的门诊女性患者治疗反应和幸福感的影响，这些患者接受了氟西汀治疗（20毫克/天，为期8周）。
根据年龄、月经不规律或闭经情况以及血管舒缩症状来定义绝经状态。抑郁症的缓解和反应分别定义为17项汉密尔顿抑郁量表（HAM-D-17）评分≤7分和HAM-D-17评分下降≥50%。通过症状问卷进行自评来评估幸福感。对病情缓解者额外随访28周。
在急性期结束时，绝经前（n = 121）、围绝经期（n = 28）和绝经后（n = 35）女性在反应率、缓解率以及幸福感水平方面均未观察到差异，即使在对基线抑郁严重程度进行调整之后。然而，除了延续期终点外，残留症状在绝经后女性中明显更为常见。在对基线抑郁严重程度进行调整后，急性期残留症状的差异消失。
总体而言，绝经状态并未显著影响重度抑郁症患者对氟西汀治疗的反应以及治疗后的幸福感程度。
