Department of Diagnosis and Treatment, Netherlands Institute of Mental Health and Addiction (Trimbos Institute), Utrecht, The Netherlands.
J Psychosom Res. 2010 Jun;68(6):511-9. doi: 10.1016/j.jpsychores.2009.11.009. Epub 2010 Jan 21.
The prognosis of depression greatly varies among patients, and the physical symptoms that often accompany depression may predict treatment resistance and a worse outcome. If so, this may have important clinical implications. The aim of this systematic review was to explore the association of concomitant physical symptoms with the outcome of major depressive disorder (MDD).
Systematic review: Medline, Psychinfo, and the Cochrane Library were searched for prospective, cross-sectional, and retrospective studies, and also for open-label trials and randomized controlled trials. The risk of bias assessment and data extraction were performed in duplicate. A qualitative best-evidence synthesis was performed, based on the number of studies reporting on the association between physical symptoms and the course of MDD, the consistency of the results, and the methodological quality. The findings were reported according to the PRISMA guidelines.
Nine studies met the inclusion criteria. Although the design, outcome measures, and data presentation varied too much to make statistical pooling possible, the best evidence synthesis resulted in strong, consistent evidence for a negative association between physical symptoms and the course of MDD.
This systematic review shows a negative association of concomitant physical symptoms with the course of MDD. The effect might be considerable, but the number of studies addressing this topic is small and there was a wide variation in the study designs and outcome measures. More research is needed.
抑郁症患者的预后差异很大，常伴随抑郁症的躯体症状可能预示着治疗抵抗和更差的结局。如果是这样，这可能具有重要的临床意义。本系统评价的目的是探讨伴随躯体症状与重度抑郁症（MDD）结局的相关性。
系统评价：对 Medline、Psychinfo 和 Cochrane 图书馆进行了前瞻性、横断面和回顾性研究的检索，也对开放标签试验和随机对照试验进行了检索。风险偏倚评估和数据提取均由两人进行。基于报告躯体症状与 MDD 病程之间相关性的研究数量、结果的一致性以及方法学质量，进行了定性最佳证据综合。根据 PRISMA 指南报告研究结果。
符合纳入标准的研究有 9 项。尽管设计、结局测量和数据呈现差异太大，无法进行统计学汇总，但最佳证据综合得出的结果表明，躯体症状与 MDD 病程之间存在负相关，具有很强的一致性。
本系统评价表明，伴随躯体症状与 MDD 病程呈负相关。这种影响可能相当大，但研究这一课题的研究数量较少，研究设计和结局测量差异很大。需要进一步研究。
