Stewart J W, McGrath P J, Quitkin F M, Harrison W, Markowitz J, Wager S, Leibowitz M R
New York State Psychiatric Institute, College of Physicians and Surgeons, NY.
Arch Gen Psychiatry. 1989 Dec;46(12):1080-7. doi: 10.1001/archpsyc.1989.01810120022005.
One hundred ninety-four nonmelancholic depressed outpatients with features of atypical depression took part in a 6-week randomized trial of imipramine hydrochloride, phenelzine sulfate, and placebo. Their courses of illness were also rated for chronicity. Significantly more patients responded to phenelzine (71%) than to imipramine (48%), which benefited significantly more patients than placebo (26%). Both chronicity and DMS-III diagnosis predicted response on several outcome measures. For example, patients with dysthymic disorder responded better to treatment than did those with major depression, suggesting that dysthymic disorder can be treated with medication. Placebo response correlated inversely with chronicity, regardless of DMS-III diagnosis. Atypical depression and longitudinal course of illness may add to the usefulness of DMS-III depressive diagnosis as a predictor of antidepressant response.
194名具有非典型抑郁特征的非忧郁性门诊抑郁症患者参与了一项为期6周的盐酸丙咪嗪、硫酸苯乙肼和安慰剂的随机试验。他们的病程也被评定为慢性程度。对硫酸苯乙肼有反应的患者（71%）显著多于对盐酸丙咪嗪有反应的患者（48%），盐酸丙咪嗪治疗有效的患者显著多于安慰剂组（26%）。慢性程度和《精神疾病诊断与统计手册》第三版（DMS - III）诊断在多项结果指标上都能预测疗效。例如，恶劣心境障碍患者对治疗的反应比重度抑郁症患者更好，这表明恶劣心境障碍可用药物治疗。无论DMS - III诊断如何，安慰剂反应与慢性程度呈负相关。非典型抑郁和疾病的纵向病程可能会增加DMS - III抑郁诊断作为抗抑郁药反应预测指标的有用性。
