Goodwin G M, Price J, De Bodinat C, Laredo J
Department of Psychiatry, University of Oxford and Oxford Health NHS Foundation Trust, The Warneford Hospital, Oxford OX3 7JX, UK.
Department of Psychiatry, University of Oxford and Oxford Health NHS Foundation Trust, The Warneford Hospital, Oxford OX3 7JX, UK.
J Affect Disord. 2017 Oct 15;221:31-35. doi: 10.1016/j.jad.2017.05.048. Epub 2017 Jun 6.
Emotional blunting is regularly reported in depressed patients on antidepressant treatment but its actual frequency is poorly understood. We have previously used qualitative methods to develop an appropriate scale, the Oxford Questionnaire on the Emotional Side-Effects of Antidepressants (OQESA).
Six hundred and sixty nine depressed patients on treatment and 150 recovered (formerly depressed) controls (aged ≥18 years) participated in this internet-based survey. The rate of emotional blunting in treated depressed patients was 46%, slightly more frequent in men than women (52% versus 44%) and in those with higher Hospital Anxiety and Depression (HAD) scale scores. There was no difference according to antidepressant agent, though it appeared less frequent with bupropion. Depressed patients with emotional blunting had much higher total blunting scores on OQESA than controls (42.83 ± 14.73 versus 25.73 ± 15.00, p < 0.0001) and there was a correlation between total blunting score and HAD-Depression score (r = 0.521). Thus, those with HAD-D score >7 (n = 170) had a higher total questionnaire score, 49.23±12.03, than those with HAD-D score ≤7 (n = 140), 35.07 ± 13.98, and the difference between the two groups was highly significant. However, patients with HAD-D score ≤7 (n = 140) had a higher total score (35.07 ± 13.98) than the recovered controls (n = 150) (25.73 ± 15.00), and the difference between the two groups was significant. Among the patients with emotional blunting, 37% had a negative perception of their condition and 38% positive. Men reported a more negative perception than women (p=0.008), and patients with a negative perception were more likely to have higher HAD scores. Higher levels of emotional blunting are associated with a more negative perception of it by the patient (r = -0.423).
Include self-evaluation and the modest size of the sample for detection of differences between antidepressants.
Emotional blunting is reported by nearly half of depressed patients on antidepressants. It appears to be common to all monoaminergic antidepressants. The OQESA scores are highly correlated with HAD depression score; emotional blunting cannot be described simply as a side-effect of antidepressants, but also as a symptom of depression. A higher degree of emotional blunting is associated with a poorer quality of remission. The OQESA scale allows the detection of this phenomenon.
接受抗抑郁治疗的抑郁症患者经常出现情感迟钝，但对其实际发生率了解甚少。我们之前使用定性方法开发了一个合适的量表，即牛津抗抑郁药情感副作用问卷（OQESA）。
669名接受治疗的抑郁症患者和150名康复（既往抑郁）对照者（年龄≥18岁）参与了这项基于互联网的调查。接受治疗的抑郁症患者中情感迟钝的发生率为46%，男性略高于女性（52%对44%），且在医院焦虑抑郁量表（HAD）得分较高的患者中更常见。不同抗抑郁药之间无差异，不过安非他酮的发生率似乎较低。有情感迟钝的抑郁症患者在OQESA上的总迟钝得分远高于对照者（42.83±14.73对25.73±15.00，p<0.0001），且总迟钝得分与HAD抑郁得分之间存在相关性（r = 0.521）。因此，HAD-D得分>7（n = （此处原文可能有误，推测应为170））的患者问卷总得分更高，为49.23±12.03，高于HAD-D得分≤7（n = 140）的患者，后者为35.07±13.98，两组间差异高度显著。然而，HAD-D得分≤7（n = 140）的患者总得分（35.07±13.98）高于康复对照者（n = 150）（25.73±15.00），两组间差异显著。在有情感迟钝的患者中，37%对自身状况有负面认知，38%有正面认知。男性报告的负面认知多于女性（p = 0.008），有负面认知的患者更可能有较高的HAD得分。情感迟钝程度越高，患者对其负面认知越强（r = -0.423）。
包括自我评估以及样本量有限难以检测不同抗抑郁药之间的差异。
近一半接受抗抑郁治疗的抑郁症患者报告有情感迟钝。这似乎在所有单胺能抗抑郁药中都很常见。OQESA得分与HAD抑郁得分高度相关；情感迟钝不能简单描述为抗抑郁药的副作用，也可视为抑郁症的一种症状。情感迟钝程度越高，缓解质量越差。OQESA量表可检测到这种现象。
