Lima Ana F, Miguel Sandro R, Cohen Mírian, Zimmermann Jacques J, Shansis Flávio M, Cruz Luciane N, Ziegelmann Patrícia K, Polanczyk Carisi A, Fleck Marcelo P
Instituto de Avaliação de Tecnologia em Saúde (IATS), Hospital de Clínicas de Porto de Alegre (HCPA), Porto Alegre, RS, Brazil.
Hospital Psiquiátrico São Pedro, Porto Alegre, RS, Brazil.
Braz J Psychiatry. 2018 Jan-Mar;40(1):26-34. doi: 10.1590/1516-4446-2016-2147. Epub 2017 Aug 21.
To assess the effectiveness of three mood disorder treatment algorithms in a sample of patients seeking care in the Brazilian public healthcare system.
A randomized pragmatic trial was conducted with an algorithm developed for treating episodes of major depressive disorder (MDD), bipolar depressive episodes and mixed episodes of bipolar disorder (BD).
The sample consisted of 259 subjects diagnosed with BD or MDD (DSM-IV-TR). After the onset of symptoms, the first treatment occurred ∼6 years and the use of mood stabilizers began ∼12 years. All proposed algorithms were effective, with response rates around 80%. The majority of the subjects took 20 weeks to obtain a therapeutic response.
The algorithms were effective with the medications available through the Brazilian Unified Health System. Because therapeutic response was achieved in most subjects by 20 weeks, a follow-up period longer than 12 weeks may be required to confirm adequate response to treatment. Remission of symptoms is still the main desired outcome. Subjects who achieved remission recovered more rapidly and remained more stable over time.
NCT02901249, NCT02870283, NCT02918097.
在巴西公共医疗系统中寻求治疗的患者样本中，评估三种情绪障碍治疗方案的有效性。
开展一项随机实用试验，采用为治疗重度抑郁症（MDD）发作、双相抑郁发作及双相情感障碍（BD）混合发作所开发的方案。
样本包括259名被诊断为BD或MDD（DSM-IV-TR）的受试者。症状出现后，首次治疗约在6年后进行，心境稳定剂的使用约在12年后开始。所有提出的方案均有效，有效率约为80%。大多数受试者需要20周才能获得治疗反应。
这些方案对通过巴西统一卫生系统可获得的药物有效。由于大多数受试者在20周时实现了治疗反应，可能需要超过12周的随访期来确认对治疗的充分反应。症状缓解仍然是主要的预期结果。实现缓解的受试者恢复得更快，且随着时间推移保持更稳定的状态。
NCT02901249、NCT02870283、NCT02918097。
