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文拉法辛缓释片对创伤后应激障碍恢复力的影响:Connor-Davidson恢复力量表的条目分析

Effects of venlafaxine extended release on resilience in posttraumatic stress disorder: an item analysis of the Connor-Davidson Resilience Scale.

作者信息

Davidson Jonathan, Baldwin David S, Stein Dan J, Pedersen Ron, Ahmed Saeed, Musgnung Jeff, Benattia Isma, Rothbaum Barbara O

机构信息

Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Trent Drive, 4th floor, Room 4082B, Durham, NC 27710, USA.

出版信息

Int Clin Psychopharmacol. 2008 Sep;23(5):299-303. doi: 10.1097/YIC.0b013e32830c202d.

Abstract

The aim was to evaluate the efficacy of venlafaxine extended release (ER) on characteristics of resilience, measured by the Connor-Davidson Resilience Scale, in patients with posttraumatic stress disorder (PTSD). Data were evaluated from a randomized, 6-month, international, multicenter study of adult outpatients with a primary diagnosis of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition PTSD for >or=6 months, and 17-item Clinician-Administered PTSD Scale score >or=60. Patients were assigned randomly to treatment with flexible-dose venlafaxine ER (37.5-300 mg/day) or placebo. Changes from baseline scores and effect sizes of response to treatment with venlafaxine ER compared with placebo were computed for each item, as well as for the newly developed 2-item and 10-item subscales. Effect sizes across items ranged from 0.41 (moderate) to 0.08 (very weak). The effect size for the Resilience Scale-2 (2-item subscale) was 0.32, which was comparable to the effect sizes of 0.35 for the 25-item full scale and 0.34 for the 10-item subscale. Venlafaxine ER improved resilience on individual Connor-Davidson Resilience Scale items that reflect four factors (hardiness, persistence/tenacity, social support, and faith in a benevolent or meaningful world), to varying degrees in patients with PTSD. The findings suggest that assessment of treatment response might be enhanced by routine evaluation of resilience.

摘要

本研究旨在评估文拉法辛缓释剂(ER)对创伤后应激障碍(PTSD)患者恢复力特征的疗效,恢复力由康纳-戴维森恢复力量表测量。数据来自一项随机、为期6个月的国际多中心研究,研究对象为成年门诊患者,其主要诊断为《精神疾病诊断与统计手册》第四版PTSD且病程≥6个月,临床医生评定的PTSD量表17项评分≥60分。患者被随机分配接受灵活剂量的文拉法辛ER(37.5 - 300毫克/天)或安慰剂治疗。计算了与安慰剂相比,文拉法辛ER治疗后各项目从基线分数的变化以及反应效应大小,同时也计算了新开发的2项和10项子量表的效应大小。各项目的效应大小范围为0.41(中等)至0.08(非常弱)。恢复力量表-2(2项子量表)的效应大小为0.32,与25项全量表的效应大小0.35以及10项子量表的效应大小0.34相当。文拉法辛ER在反映四个因素(坚韧、坚持/顽强、社会支持以及对美好或有意义世界的信念)的康纳-戴维森恢复力量表各单项上,不同程度地改善了PTSD患者的恢复力。研究结果表明,通过对恢复力的常规评估可能会增强对治疗反应的评估。

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