Miller Mark D, Paradis Cynthia F, Houck Patricia R, Rifai A Hind, Mazumdar Sati, Pollock Bruce, Perel James M, Frank Ellen, Reynolds Charles F
Mental Health Clinical Research Center for the Study of Late-Life Mood Disorders, Dept. of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA.
Am J Geriatr Psychiatry. 1996;4(4):281-290. doi: 10.1097/00019442-199622440-00002. Epub 2012 Aug 15.
The authors treated 115 elderly patients (ambulatory and without dementia) with recurrent major depression, by means of combined nortriptyline and interpersonal psychotherapy. They contrasted Cumulative Illness Rating Scale-Geriatric (CIRS-G) scores (for medical burden) in recovered and nonrecovered patients and generated a Cox proportional-hazards model of time-to-remission. The authors found no association between pretreatment chronic medical burden and acute treatment outcome in recovered (83 of 115) and nonrecovered patients and no relation of pretreatment CIRS-G scores with time-to-recovery. Findings support recent recommendations that practitioners be optimistic in treating elderly depressed, ambulatory patients whether or not significant medical burden coexists.
作者们采用去甲替林与人际心理治疗相结合的方法，对115名患有复发性重度抑郁症的老年患者（可走动且无痴呆症）进行了治疗。他们对比了康复患者和未康复患者的累积疾病评定量表-老年版（CIRS-G）评分（用于衡量医疗负担），并建立了一个缓解时间的Cox比例风险模型。作者们发现，在康复患者（115名中的83名）和未康复患者中，治疗前的慢性医疗负担与急性治疗结果之间没有关联，治疗前的CIRS-G评分与康复时间也没有关系。这些发现支持了最近的建议，即从业者在治疗可走动的老年抑郁症患者时应保持乐观态度，无论是否存在重大医疗负担。
