Dell'Osso Bernardo, Cremaschi Laura, Grancini Benedetta, De Cagna Francesca, Benatti Beatrice, Camuri Giulia, Arici Chiara, Dobrea Cristina, Oldani Lucio, Palazzo Maria Carlotta, Vismara Matteo, Altamura A Carlo
Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.
Department of Psychiatry and Behavioral Sciences, Bipolar Disorders Clinic, Stanford Medical School, Stanford University, Stanford, CA, USA.
Int J Clin Pract. 2017 Feb;71(2). doi: 10.1111/ijcp.12926. Epub 2017 Jan 15.
Previous investigation on the duration of untreated illness (DUI) in patients with Major Depressive Disorder (MDD) revealed a different latency to first antidepressant treatment, with adverse consequences in terms of outcome for individuals with a longer DUI. Recent reports, moreover, documented a reduced DUI, as observed with the passage of time, in patients with different psychiatric disorders. Hence, the present study was aimed to assess DUI and related variables in a sample of Italian patients with MDD as well as to investigate potential differences in subjects with onset before and after 2000.
An overall sample of 188 patients with MDD was assessed through a specific questionnaire investigating DUI and other variables related to the psychopathological onset and latency to first antidepressant treatment, after dividing them in two different subgroups on the basis of their epoch of onset.
The whole sample showed a mean DUI of approximately 4.5 years, with patients with more recent onset showing a significantly shorter latency to treatment compared with the other group (27.1±42.6 vs 75.8±105.2 months, P<.05). Other significant differences emerged between the two subgroups, in terms of rates of onset-related stressful events and benzodiazepine prescription, respectively, higher and lower in patients with more recent onset.
Our findings indicate a significant DUI reduction in MDD patients whose onset occurred after vs before 2000, along with other relevant differences in terms of onset-related correlates and first pharmacotherapy. Further studies with larger samples are warranted to confirm the present findings in Italy and other countries.
先前对重度抑郁症(MDD)患者未治疗疾病持续时间(DUI)的调查显示,首次抗抑郁药治疗的潜伏期不同,DUI较长的个体在预后方面会产生不良后果。此外,最近的报告记录了随着时间推移,不同精神疾病患者的DUI有所缩短。因此,本研究旨在评估一组意大利MDD患者的DUI及相关变量,并调查2000年之前和之后发病的患者之间的潜在差异。
通过一份特定问卷对188例MDD患者的总体样本进行评估,该问卷调查了DUI以及与精神病理发作和首次抗抑郁药治疗潜伏期相关的其他变量,并根据发病时间将他们分为两个不同的亚组。
整个样本的平均DUI约为4.5年,与另一组相比,近期发病的患者治疗潜伏期明显更短(27.1±42.6个月对75.8±105.2个月,P<0.05)。两个亚组之间在与发病相关的应激事件发生率和苯二氮䓬类药物处方方面分别出现了其他显著差异,近期发病的患者中这两项指标分别更高和更低。
我们的研究结果表明,2000年之后发病的MDD患者的DUI显著缩短,同时在与发病相关的关联因素和首次药物治疗方面也存在其他相关差异。有必要进行更大样本的进一步研究,以在意大利和其他国家证实本研究结果。