Psychiatric Research Unit, Frederiksborg General Hospital, Hillerød, Denmark.
Pharmacopsychiatry. 2010 Nov;43(7):271-6. doi: 10.1055/s-0030-1263173. Epub 2010 Sep 9.
This retrospective analysis compared sensitivity to change on the 17-item and 6-item Hamilton Rating Scales For Depression (HAM-D (17) and HAM-D (6), respectively) in relation to antidepressant dose and baseline depression severity.
Data were derived from 6 randomized, double-blind, placebo-controlled, 8-week trials of fixed-dose desvenlafaxine (50, 100, 200 or 400 mg/d) for major depressive disorder. HAM-D (17) and HAM-D (6) effect sizes were assessed.
HAM-D (17) effect sizes were negative (favoured placebo) for higher desvenlafaxine doses (200-400 mg/d) at week 1, but were positive for all doses after week 2, with no clear dose-response pattern. However, HAM-D (6) effect sizes were positive for all doses at all weeks. Effect sizes were consistently greater for HAM-D (6) vs. HAM-D (17), regardless of time spent under therapy. Effect sizes were greater for HAM-D (6) vs. HAM-D (17) for all desvenlafaxine doses among patients with baseline HAM-D (17) <25, but not among patients with baseline HAM-D (17) ≥ 25.
The HAM-D (6) demonstrated greater sensitivity to change and robustness than the HAM-D (17), supporting the greater homogeneity of the HAM-D (6).
本回顾性分析比较了分别使用汉密尔顿抑郁量表 17 项版本（HAM-D（17））和汉密尔顿抑郁量表 6 项版本（HAM-D（6））时，抗抑郁药剂量和基线抑郁严重程度与变化敏感性的关系。
数据来自 6 项随机、双盲、安慰剂对照、为期 8 周的固定剂量去甲文拉法辛治疗重度抑郁症的试验。评估了 HAM-D（17）和 HAM-D（6）的效应量。
HAM-D（17）的效应量在较高去甲文拉法辛剂量（200-400mg/d）的第 1 周为负值（有利于安慰剂），但在第 2 周后所有剂量均为正值，没有明显的剂量反应模式。然而，HAM-D（6）的效应量在所有周内对所有剂量均为正值。无论治疗时间如何，HAM-D（6）的效应量始终大于 HAM-D（17）。对于基线 HAM-D（17）<25 的患者，所有去甲文拉法辛剂量的 HAM-D（6）与 HAM-D（17）相比，效应量均较大，但对于基线 HAM-D（17）≥25 的患者则并非如此。
HAM-D（6）显示出比 HAM-D（17）更大的变化敏感性和稳健性，支持 HAM-D（6）具有更大的同质性。
