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老年抑郁症患者的执行功能障碍主诉与艾司西酞普兰治疗反应

Executive functioning complaints and escitalopram treatment response in late-life depression.

作者信息

Manning Kevin J, Alexopoulos George S, Banerjee Samprit, Morimoto Sarah Shizuko, Seirup Joanna K, Klimstra Sibel A, Yuen Genevieve, Kanellopoulos Theodora, Gunning-Dixon Faith

机构信息

Weill Cornell Institute of Geriatric Psychiatry, White Plains, NY.

Weill Cornell Institute of Geriatric Psychiatry, White Plains, NY.

出版信息

Am J Geriatr Psychiatry. 2015 May;23(5):440-5. doi: 10.1016/j.jagp.2013.11.005. Epub 2013 Nov 27.

Abstract

OBJECTIVE

Executive dysfunction may play a key role in the pathophysiology of late-life depression. Executive dysfunction can be assessed with cognitive tests and subjective report of difficulties with executive skills. The present study investigated the association between subjective report of executive functioning complaints and time to escitalopram treatment response in older adults with major depressive disorder (MDD).

METHODS

100 older adults with MDD (58 with executive functioning complaints and 42 without executive functioning complaints) completed a 12-week trial of escitalopram. Treatment response over 12 weeks, as measured by repeated Hamilton Depression Rating Scale scores, was compared for adults with and without executive complaints using mixed-effects modeling.

RESULTS

Mixed effects analysis revealed a significant group × time interaction, F(1, 523.34) = 6.00, p = 0.01. Depressed older adults who reported executive functioning complaints at baseline demonstrated a slower response to escitalopram treatment than those without executive functioning complaints.

CONCLUSION

Self-report of executive functioning difficulties may be a useful prognostic indicator for subsequent speed of response to antidepressant medication.

摘要

目的

执行功能障碍可能在老年期抑郁症的病理生理学中起关键作用。执行功能障碍可通过认知测试和执行技能困难的主观报告进行评估。本研究调查了患有重度抑郁症(MDD)的老年人执行功能障碍主诉的主观报告与艾司西酞普兰治疗反应时间之间的关联。

方法

100名患有MDD的老年人(58名有执行功能障碍主诉,42名无执行功能障碍主诉)完成了一项为期12周的艾司西酞普兰试验。使用混合效应模型比较了有和没有执行功能障碍主诉的成年人在12周内的治疗反应,反应通过重复的汉密尔顿抑郁量表评分来衡量。

结果

混合效应分析显示出显著的组×时间交互作用,F(1, 523.34) = 6.00,p = 0.01。在基线时报告有执行功能障碍主诉的抑郁老年人对艾司西酞普兰治疗的反应比没有执行功能障碍主诉的老年人慢。

结论

执行功能困难的自我报告可能是后续对抗抑郁药物反应速度的一个有用的预后指标。

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