Demyttenaere Koen, Adelin Albert, Patrick Mesters, Walthère Dewé, Katrien De Bruyckere, Michèle Sangeleer
University Hospital Gasthuisberg, Belgium.
Int Clin Psychopharmacol. 2008 Jan;23(1):36-42. doi: 10.1097/YIC.0b013e3282f1c1d8.
The investigation of compliance in patients with major depressive disorder (in drop-outs versus completers and in first episode versus recurrent episode patients). A total of 85 outpatients with major depressive disorder were followed for 6 months. Different dimensions of compliance were investigated: drop-outs versus completers and their medication adherence (with electronic monitoring). General linear mixed models were applied to examine the time courses of adherence. Drop-out rates were higher in younger patients and in patients with a lower initial depression severity. The adherence during 6 months of treatment with selective serotonin reuptake inhibitors was above 80 in 70% of the patients. The adherence decreased by 2.5% per month and decreased more than three times more rapidly in drop-outs (from baseline to time of drop-out). A medical visit resulted in a temporary increase in pill intake. General linear mixed model analysis showed that the predicted outcome was worse in drop-outs than in completers and worse in recurrent episode patients than in first episode patients (the former showing a higher adherence). Adherence decreases with time during 6 months of treatment with antidepressants and is influenced by demographic and clinical variables. Completers show a higher adherence than drop-outs. The outcome was worse in recurrent episode patients than first episode patients although they had a higher adherence.
重度抑郁症患者依从性的调查（脱落者与完成治疗者以及首发患者与复发患者）。共对85名重度抑郁症门诊患者进行了6个月的随访。研究了依从性的不同维度：脱落者与完成治疗者及其药物依从性（通过电子监测）。应用广义线性混合模型来检查依从性的时间进程。年轻患者和初始抑郁严重程度较低的患者脱落率较高。在70%的患者中，使用选择性5-羟色胺再摄取抑制剂治疗6个月期间的依从性高于80%。依从性每月下降2.5%，在脱落者中下降速度比这快三倍多（从基线到脱落时）。一次就诊导致药丸摄入量暂时增加。广义线性混合模型分析表明，脱落者的预测结果比完成治疗者差，复发患者的预测结果比首发患者差（前者依从性较高）。在使用抗抑郁药治疗的6个月期间，依从性随时间下降，并受人口统计学和临床变量影响。完成治疗者的依从性高于脱落者。复发患者的结果比首发患者差，尽管他们的依从性较高。
