Posternak Michael A, Zimmerman Mark
Depression Clinical and Research Program, Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, 50 Staniford Street, Suite 4 01, Boston, MA 02114, USA.
Br J Psychiatry. 2007 Apr;190:287-92. doi: 10.1192/bjp.bp.106.028555.
It remains unclear how much various factors contribute to the placebo response.
To estimate the therapeutic impact of follow-up assessments on placebo response in antidepressant trials.
Double-blind, placebo-controlled antidepressant trials that reported weekly changes in Hamilton Rating Scale for Depression (HRSD) scores over 6 weeks were selected. Included studies (n=41) were divided into those that conducted four, five or six follow-up assessments. Reductions in HRSD scores as a function of the different follow-up schedules were compared.
An extra follow-up visit at week 3 was associated with a 0.86 further reduction in HRSD score; an extra visit at week 5 was associated with a 0.67 further reduction. These effects represented approximately 34-44% of the placebo response that occurred over these time frames. Two additional visits were associated with twice the reduction in HRSD score than one, suggesting that the therapeutic impact of assessment visits is cumulative and proportional. A comparable therapeutic effect was also found in participants receiving active medication.
Follow-up assessments in antidepressant treatment trials incur a significant therapeutic effect for participants on placebo, and this represents about 40% of the placebo response.
目前尚不清楚各种因素对安慰剂反应的影响程度。
评估随访评估在抗抑郁试验中对安慰剂反应的治疗效果。
选择双盲、安慰剂对照的抗抑郁试验，这些试验报告了汉密尔顿抑郁评定量表（HRSD）评分在6周内的每周变化。纳入的研究（n = 41）分为进行四次、五次或六次随访评估的研究。比较了不同随访计划下HRSD评分的降低情况。
在第3周增加一次随访与HRSD评分进一步降低0.86相关；在第5周增加一次随访与HRSD评分进一步降低0.67相关。这些效应约占这些时间段内安慰剂反应的34 - 44%。增加两次随访导致HRSD评分降低幅度是增加一次随访的两倍，这表明评估访视的治疗效果是累积的且成比例。在接受活性药物治疗的参与者中也发现了类似的治疗效果。
抗抑郁治疗试验中的随访评估对接受安慰剂的参与者产生了显著的治疗效果，这约占安慰剂反应的40%。
