Kai-Suan Psychiatric Hospital, Kaohsiung, Taiwan.
Psychiatry Clin Neurosci. 2011 Aug;65(5):510-7. doi: 10.1111/j.1440-1819.2011.02235.x.
The goal of treating major depressive disorder is to achieve remission. This prospective study aimed to identify predictors of remission in a cohort of depressive inpatients who received fluoxetine.
A total of 131 newly hospitalized patients with major depressive disorder received a fixed dose of 20 mg/day (the recommended dose from the literature) of fluoxetine for 6 weeks. Symptom severity was assessed using the 17-item Hamilton Depression Rating Scale at weeks 0, 1, 2, 3, 4 and 6. Remission was defined as a score of ≤7 on the 17-item Hamilton Depression Rating Scale after 6 weeks of treatment. We compared the remitters and non-remitters in terms of baseline variables. The Short-Form-36 pain interference item was used to assess pain. It was classified as high (score ≥ 3) or low (score < 3).
A total of 31 (27.7%) of 112 completers remitted after 6 weeks of treatment. The remitters and non-remitters did not differ in baseline variables, except pain interference, baseline depression severity, and depression improvement at week 1.
These findings obtained from newly hospitalized major depression patients support the previous notion that pain interference, depression severity, and early improvement can be the predictors for remission. Patients with high pain interference, a greater depression severity or a less early improvement are likely to require aggressive treatment early. These data require confirmation and extension to outpatients and other antidepressants.
治疗重度抑郁症的目标是实现缓解。本前瞻性研究旨在确定接受氟西汀治疗的住院抑郁症患者队列中缓解的预测因素。
共有 131 名新住院的重度抑郁症患者接受了 20 毫克/天(文献推荐剂量)的氟西汀固定剂量治疗 6 周。在第 0、1、2、3、4 和 6 周使用 17 项汉密尔顿抑郁量表评估症状严重程度。缓解定义为治疗 6 周后 17 项汉密尔顿抑郁量表评分≤7。我们比较了缓解者和未缓解者在基线变量方面的差异。使用 36 项简短健康调查问卷疼痛干扰项来评估疼痛。它被分为高(评分≥3)或低(评分<3)。
共有 112 名完成者中的 31 名(27.7%)在 6 周治疗后缓解。缓解者和未缓解者在基线变量方面没有差异,除了疼痛干扰、基线抑郁严重程度和第 1 周的抑郁改善。
这些从新住院的重度抑郁症患者中获得的发现支持了先前的观点,即疼痛干扰、抑郁严重程度和早期改善可以是缓解的预测因素。疼痛干扰高、抑郁严重程度大或早期改善少的患者可能需要早期积极治疗。这些数据需要在门诊患者和其他抗抑郁药中得到证实和扩展。