ten Doesschate Mascha C, Bockting Claudi L H, Schene Aart H
Academic Medical Centre, Department of Psychiatry, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands.
J Affect Disord. 2009 May;115(1-2):167-70. doi: 10.1016/j.jad.2008.07.011. Epub 2008 Aug 28.
In chronic diseases adherence is a problem. Little is known about adherence to antidepressants after the acute phase in recurrent depression. This study evaluates adherence to antidepressants in the continuation and maintenance phase in remitted recurrently depressed patients.
We prospectively assessed adherence to continuation and maintenance antidepressant use, the longest phase in antidepressant treatment, over 2 years and the association of adherence with future recurrence in 131 recurrently depressed patients remitted on antidepressants.
Self reported non-adherence.
Non-adherence ranged from 39.7% to 52.7%; 20.9% were always non-adherent, 48.4% were intermittently non-adherent and 30.8% were always adherent. Adherence rates did not significantly differ between intermittent and continuous antidepressant users (37.2% vs. 25%). Non-adherence predicted time to recurrence.
Non-adherence to continuation and maintenance antidepressant treatment in recurrent depression is frequent, like in other chronic diseases, and a potential risk of recurrence. Doctors continuously have to be aware of this problem and should keep on discussing it with their patients. Finally, as many patients don't seem to be able or willing to take AD as prescribed, alternatives to prevent relapse deserve more attention.
在慢性病中，依从性是一个问题。对于复发性抑郁症急性期过后对抗抑郁药的依从性了解甚少。本研究评估了缓解期复发性抑郁症患者在巩固期和维持期对抗抑郁药的依从性。
我们前瞻性地评估了131例在抗抑郁药治疗下病情缓解的复发性抑郁症患者在长达2年的抗抑郁药巩固和维持治疗（抗抑郁治疗最长阶段）中的依从性，以及依从性与未来复发的关联。
自我报告的不依从情况。
不依从率在39.7%至52.7%之间；20.9%的患者始终不依从，48.4%的患者间歇性不依从，30.8%的患者始终依从。间歇性和持续性抗抑郁药使用者的依从率无显著差异（37.2%对25%）。不依从可预测复发时间。
与其他慢性病一样，复发性抑郁症患者在巩固期和维持期对抗抑郁药治疗的不依从情况很常见，且是复发的潜在风险。医生必须持续关注这一问题，并应不断与患者进行讨论。最后，由于许多患者似乎无法或不愿意按规定服用抗抑郁药，预防复发的替代方法值得更多关注。
