University of South Florida, Tampa, Florida, USA.
Int Clin Psychopharmacol. 2011 Mar;26(2):75-83. doi: 10.1097/YIC.0b013e328341bb5f.
Relatively little research has focused on the relationship between functional remission and symptomatic remission in mood and anxiety disorders. This study investigates the relationship and synchrony between symptomatic and functional remission in outpatients with major depressive disorder (MDD) and generalized anxiety disorder (GAD). Using data from three MDD (N=1419) and four GAD (N=1847) randomized, placebo-controlled duloxetine studies, we calculated the percentages of patients meeting symptomatic, functional, and combined functional-symptomatic remission criteria for each disorder. We also calculated mean depression [17-item Hamilton depression rating scale (HAMD₁₇), Montgomery-Asberg depression rating scale] scores and mean anxiety (Hamilton anxiety rating scale) scores for patients meeting Sheehan disability scale (SDS) functional remission and the mean SDS scores for patients with symptomatic remission. Among the patients with MDD, 38% achieved symptomatic remission (HAMD₁₇ ≤ 7), 32% achieved functional remission (SDS ≤ 6), and 23% achieved combined functional-symptomatic remission. Mean HAMD₁₇ and Montgomery-Asberg depression rating scale scores for patients with functional remission were approximately 6. Mean SDS total scores for patients with symptomatic remission were 7.1 (patients with HAMD₁₇ ≤ 7) and 8.6 (patients with Montgomery-Asberg depression rating scale ≤ 10). Among the patients with GAD, 30% achieved symptomatic remission (Hamilton anxiety rating scale ≤ 7), 45% achieved functional remission (SDS ≤ 6), and 25% achieved combined symptomatic-functional remission. The mean Hamilton anxiety rating scale score in GAD was approximately 8 for patients with functional remission and the mean SDS total score was approximately 4 in patients with symptomatic remission. The study shows that functional remission does not always move in tandem with symptom remission and provides useful anchor points or rules of thumb for evaluating symptomatic and functional remission in MDD and GAD.
在心境和焦虑障碍中,功能缓解与症状缓解之间的关系相对较少受到关注。本研究调查了重性抑郁障碍(MDD)和广泛性焦虑障碍(GAD)门诊患者症状缓解和功能缓解之间的关系和同步性。使用来自三项 MDD(N=1419)和四项 GAD(N=1847)的随机、安慰剂对照度洛西汀研究的数据,我们计算了每种疾病符合症状缓解、功能缓解和联合功能-症状缓解标准的患者百分比。我们还计算了符合 Sheehan 残疾量表(SDS)功能缓解的患者的平均抑郁[17 项汉密尔顿抑郁量表(HAMD₁₇),蒙哥马利-阿斯伯格抑郁评定量表]评分和平均焦虑(Hamilton 焦虑量表)评分,以及符合症状缓解的患者的平均 SDS 评分。在 MDD 患者中,38%达到症状缓解(HAMD₁₇≤7),32%达到功能缓解(SDS≤6),23%达到联合功能-症状缓解。功能缓解患者的平均 HAMD₁₇和蒙哥马利-阿斯伯格抑郁评定量表评分约为 6。症状缓解患者的 SDS 总分平均为 7.1(HAMD₁₇≤7 的患者)和 8.6(蒙哥马利-阿斯伯格抑郁评定量表≤10 的患者)。在 GAD 患者中,30%达到症状缓解(Hamilton 焦虑量表≤7),45%达到功能缓解(SDS≤6),25%达到联合症状-功能缓解。功能缓解的 GAD 患者的平均 Hamilton 焦虑量表评分为 8,症状缓解患者的 SDS 总分平均为 4。研究表明,功能缓解并不总是与症状缓解同步,为评估 MDD 和 GAD 的症状缓解和功能缓解提供了有用的锚点或经验法则。