Kocsis James H, Gelenberg Alan J, Rothbaum Barbara, Klein Daniel N, Trivedi Madhukar H, Manber Rachel, Keller Martin B, Howland Robert, Thase Michael E
Department of Psychiatry, Weill-Cornell Medical Center, 525 East 68th Street, New York, NY 10021, USA.
J Affect Disord. 2008 Sep;110(1-2):55-61. doi: 10.1016/j.jad.2008.01.002. Epub 2008 Feb 12.
During a multisite, NIMH-sponsored clinical trial entitled, "Research Evaluating the Value of Augmentation of Medication by Psychotherapy" (REVAMP), we assessed the adequacy of prior antidepressant treatment in patients with chronic forms of major depressive disorder using the Antidepressant Treatment History Form (ATHF). We hypothesized that when compared to earlier studies treatment adequacy would not have increased over the past decade. We found that only 33% of the 801 subjects enrolled had ever had a prior adequate trial of antidepressant medication. Patients significantly more likely to have received prior adequate antidepressant trials were older, married, white, had a longer duration of illness, had more melancholic features or met criteria for the melancholic subtype or met lifetime criteria for panic disorder. The hypothesis that rates of treatment adequacy have not significantly increased over the past decade was supported. These results and the consistency of similar results over time point to the dire need for patient and provider education regarding the signs and symptoms of depression and its treatment.
在一项由美国国立精神卫生研究所（NIMH）资助的多中心临床试验“研究评估心理治疗增强药物疗效的价值”（REVAMP）中，我们使用抗抑郁治疗史表格（ATHF）评估了患有慢性重度抑郁症患者先前抗抑郁治疗的充分性。我们假设，与早期研究相比，过去十年中治疗充分性不会有所提高。我们发现，在招募的801名受试者中，只有33%的人曾接受过充分的抗抑郁药物试验。更有可能接受过充分抗抑郁试验的患者年龄较大、已婚、为白人、病程较长、具有更多抑郁特征或符合抑郁亚型标准或符合惊恐障碍的终生标准。过去十年中治疗充分率未显著提高这一假设得到了支持。这些结果以及类似结果随时间的一致性表明，迫切需要对患者和医疗服务提供者进行关于抑郁症的症状及其治疗的教育。
