Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan.
Neuropsychiatr Dis Treat. 2014 Apr 8;10:599-606. doi: 10.2147/NDT.S57189. eCollection 2014.
We investigated cutoff values for the early response of patients with major depressive disorder to paroxetine and their sex differences by using a receiver operating characteristic (ROC) curve analysis to predict the effectiveness of paroxetine.
In total, 120 patients with major depressive disorder were enrolled and treated with 10-40 mg/day paroxetine for 6 weeks; 89 patients completed the protocol. A clinical evaluation using the Montgomery-Asberg Depression Rating Scale (MADRS) was performed at weeks 0, 1, 2, 4, and 6.
In male subjects, the cutoff values for MADRS improvement rating in week 1, week 2, and week 4 were 20.9%, 34.9%, and 33.3%, respectively. The sensitivities and the specificities were 83.3% and 80.0%, 83.3% and 80.0%, and 100% and 90%, respectively. The areas under the curve (AUC) were 0.908, 0.821, and 0.979, respectively. In female subjects, the cutoff values for the MADRS improvement rating in week 1, week 2, and week 4 were 21.4%, 35.7%, and 32.3%, respectively. The sensitivities and the specificities were 71.4% and 84.6%, 73.8% and 76.9%, and 90.5% and 76.9%, respectively. The AUCs were 0.781, 0.735, and 0.904, respectively.
Early improvement with paroxetine may predict the long-term response. The accuracy of the prediction for the response is higher in male subjects.
我们通过接受者操作特征（ROC）曲线分析，探讨了帕罗西汀治疗重度抑郁症患者早期应答的截断值及其性别差异，以预测帕罗西汀的疗效。
共纳入 120 例重度抑郁症患者，给予帕罗西汀 10-40mg/d 治疗 6 周；89 例完成方案。在 0、1、2、4 和 6 周时采用蒙哥马利-阿斯伯格抑郁评定量表（MADRS）进行临床评估。
在男性患者中，第 1、2 和 4 周时 MADRS 改善评分的截断值分别为 20.9%、34.9%和 33.3%。敏感度和特异度分别为 83.3%和 80.0%、83.3%和 80.0%、100%和 90%。曲线下面积（AUC）分别为 0.908、0.821 和 0.979。在女性患者中，第 1、2 和 4 周时 MADRS 改善评分的截断值分别为 21.4%、35.7%和 32.3%。敏感度和特异度分别为 71.4%和 84.6%、73.8%和 76.9%、90.5%和 76.9%。AUC 分别为 0.781、0.735 和 0.904。
帕罗西汀早期改善可能预测长期反应。男性患者预测反应的准确性更高。
