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米氮平治疗重性抑郁障碍短期安慰剂对照研究中自杀行为风险的纵向分析。

Longitudinal analysis of the suicidal behaviour risk in short-term placebo-controlled studies of mirtazapine in major depressive disorder.

机构信息

Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria.

出版信息

World J Biol Psychiatry. 2010 Feb;11(1):36-44. doi: 10.3109/15622970701691503.

Abstract

OBJECTIVE

To examine suicidal behaviour risk in the short-term placebo-controlled studies of mirtazapine in Major Depressive Disorder (MDD).

METHOD

Longitudinal Generalized Estimating Equations analyses were performed on pooled data from 15 placebo-controlled, randomized, double-blind, short-term trials of mirtazapine, using the suicide item scores from the Hamilton Depression Rating Scale (HAMD) as a proxy outcome measure for suicidality risk.

RESULTS

The overall analysis using the convention that a patient is at risk if the HAMD suicide item score is > or =3, and excluding patients at risk at baseline, demonstrated a statistically significantly lower risk for mirtazapine- compared to placebo-treated patients on the HAMD (odds ratio mirtazapine versus placebo 0.38; 95% confidence interval 0.21-0.66; P= 0.0008).

CONCLUSION

Our results based on pooled data from 15 placebo-controlled, short-term studies of mirtazapine in MDD using the suicide item scores from the HAMD as a proxy outcome measure for suicidality risk, demonstrate that mirtazapine was associated with statistically significantly lower suicidality risk compared to placebo.

摘要

目的

考察米氮平治疗重度抑郁症(MDD)的短期安慰剂对照研究中短期的自杀行为风险。

方法

使用汉密尔顿抑郁评定量表(HAMD)的自杀项目评分作为自杀风险的替代结果指标,对米氮平 15 项安慰剂对照、随机、双盲、短期试验的汇总数据进行纵向广义估计方程分析。

结果

采用如果 HAMD 自杀项目评分≥3 则认为患者存在风险的常规方法,并且排除基线时存在风险的患者,总体分析显示米氮平治疗组患者的 HAMD 评分自杀风险显著低于安慰剂组(米氮平与安慰剂的比值比为 0.38;95%置信区间为 0.21-0.66;P=0.0008)。

结论

我们的研究结果基于米氮平治疗 MDD 的 15 项短期安慰剂对照研究的汇总数据,使用 HAMD 的自杀项目评分作为自杀风险的替代结果指标,表明与安慰剂相比,米氮平与自杀风险显著降低相关。

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