López-Ibor Aliño J J, Chinchilla A, Vega M, Sánchez P, Camarero M, Jordá L, Viñas R, Moreno I
Actas Luso Esp Neurol Psiquiatr Cienc Afines. 1989 Jul-Aug;17(4):223-30.
A group of 89 patients admitted to the Psychiatric Unit of a General Hospital, with diagnosis of depression according to ICD-9 criteria and randomly chosen were studied. 26 of them (29.2%) were resistant depressions and 63 (7.82%) responded to treatment. Both groups were composed retrospectively in order to analyse resistance or lack of response to a first treatment with tricyclic or tetracyclic antidepressants in effective dosages. We considered: the personality type; the associated somatic pathology; prolonged social stress; period of evolution of the disorder; previous treatments; type of disorder uni or bipolar; familial morbidity; diagnosis reconsideration; analysis of therapeutic compliance; side effects and intolerance. We observed a statistically significant difference with regard to prophylactic treatment (38.4% resistant versus 98.3% non-resistant, p less than 0.0001); a greater suspicion of psycho-organicity in the resistant group (p less than 0.05); a longer interval of time for the resistant group between the beginning of the disorder and the beginning of treatment in our service (F: 1.45, t: 2.58, p less than 0.01). The alternatives used with our patients are analysed and we propose schedules for tackling this kind of problem.
选取了综合医院精神科收治的89例患者进行研究，这些患者均根据国际疾病分类第九版（ICD - 9）标准诊断为抑郁症，且为随机选取。其中26例（29.2%）为难治性抑郁症，63例（70.8%）对治疗有反应。为分析对有效剂量三环或四环抗抑郁药首次治疗的耐药性或无反应情况，对两组进行了回顾性分析。我们考虑了：人格类型；相关躯体病理学；长期社会压力；疾病演变期；既往治疗；单相或双相障碍类型；家族发病率；诊断重新考虑；治疗依从性分析；副作用和不耐受情况。我们观察到在预防性治疗方面存在统计学显著差异（耐药组为38.4%，非耐药组为98.3%，p < 0.0001）；耐药组中对精神器质性病变的怀疑度更高（p < 0.05）；耐药组在疾病开始至我院治疗开始之间的时间间隔更长（F：1.45，t：2.58，p < 0.01）。对我们治疗患者所采用的替代方法进行了分析，并提出了解决这类问题的方案。
