Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Germany.
Eur Neuropsychopharmacol. 2010 May;20(5):346-55. doi: 10.1016/j.euroneuro.2009.11.011. Epub 2010 Jan 22.
Due to strict exclusion criteria the generalizability of randomized controlled trials appears to be limited. Therefore, outcomes of naturalistically treated depressive inpatients with respect to depression mean scores, response and remission rates were evaluated. This was a multicenter trial, conducted in 12 psychiatric hospitals in Germany with a follow-up period of 4years. Patients were assessed biweekly from admission to discharge with diverse psychopathological rating scales. All patients (n=1014) met DSM-IV criteria for major depressive episode. Results are presented only for the acute inpatient treatment period. Mean inpatient treatment duration was 53.6+/-47.5days. Reduction on depression scales was evident as soon as week 2 and remained significant. Mean HAMD-17 total score decreased from 22.3 to 8.8. A total of 68.9% were classified as responders (> or =50% reduction of the initial HAMD-17 score), whereas 51.9% achieved remission (HAMD-17 total score < or =7). Of those who ultimately achieved response more than 40% did so within the first 2weeks. An individualized naturalistic inpatient treatment approach appears to be beneficial in terms of effectiveness.
由于严格的排除标准，随机对照试验的普遍性似乎受到限制。因此，评估了自然治疗的住院抑郁症患者在抑郁平均得分、反应和缓解率方面的结果。这是一项多中心试验，在德国的 12 家精神病院进行，随访期为 4 年。患者在入院至出院期间每周接受两次不同的心理病理评定量表评估。所有患者（n=1014）均符合 DSM-IV 重性抑郁发作标准。结果仅呈现急性住院治疗期间的数据。平均住院治疗时间为 53.6+/-47.5 天。抑郁量表的减少在第 2 周就明显且持续显著。汉密尔顿抑郁量表 17 项总分从 22.3 降至 8.8。共有 68.9%的患者被归类为应答者（初始汉密尔顿抑郁量表 17 项评分降低≥50%），而 51.9%的患者达到缓解（汉密尔顿抑郁量表 17 项总分<或=7）。那些最终达到反应的患者中，超过 40%的患者在头 2 周内达到反应。个体化的自然住院治疗方法在疗效方面似乎是有益的。
