Chiba Hiromi, Oe Misari, Uchimura Naohisa
Department of Neuropsychiatry, Kurume University School of Medicine.
Kurume Med J. 2016;62(1-2):23-8. doi: 10.2739/kurumemedj.MS65010. Epub 2016 Feb 15.
Major depressive disorder (MDD) has been associated with stressful life events and with posttraumatic stress disorder (PTSD). PTSD and MDD comorbidity was also reported to be associated with greater symptom severity and lower levels of functioning. However, the characteristics of pharmacotherapy for PTSD with MDD are not fully understood. To understand this relationship, we conducted a retrospective review using medical charts at the Department of Neuropsychiatry, Kurume University Hospital. Information from 55 patients with PTSD was analyzed. Five cases were excluded after re-evaluation of the PTSD diagnosis. A higher rate of type II trauma was observed in the PTSD with MDD group (50.0%) than in the PTSD-only group [13.6%; χ(2) (1, n =50) = 7.26, p<0.01]. Patients with comorbid MDD were significantly older, had more severe PTSD symptomatology, and a longer duration of treatment. They also received higher doses of psychotropic drugs, regardless of the type (antidepressants, antipsychotics, benzodiazepines), than the PTSD-only group. Our results showed that comorbid MDD is associated with higher doses of psychotropic drugs, suggesting difficulties in treatment.
重度抑郁症(MDD)与应激性生活事件以及创伤后应激障碍(PTSD)有关。据报道,PTSD与MDD共病还与更严重的症状和更低的功能水平相关。然而,PTSD合并MDD的药物治疗特点尚未完全明确。为了解这种关系,我们对久留米大学医院神经精神科的病历进行了回顾性研究。分析了55例PTSD患者的信息。在对PTSD诊断进行重新评估后,排除了5例患者。与仅患PTSD的组相比,PTSD合并MDD组(50.0%)的II型创伤发生率更高[13.6%;χ(2)(1, n =50)=7.26,p<0.01]。MDD共病患者年龄显著更大,PTSD症状更严重,治疗持续时间更长。与仅患PTSD的组相比,他们还接受了更高剂量的精神药物治疗,无论药物类型(抗抑郁药、抗精神病药、苯二氮䓬类药物)如何。我们的结果表明,MDD共病与更高剂量的精神药物治疗相关,提示治疗存在困难。