对于接受氟西汀或电抽搐治疗的抑郁症患者，汉密尔顿抑郁量表（HAMD-17）和 HAMD-6 评分的早期改善可预测最终的反应和缓解。

Early improvement in HAMD-17 and HAMD-6 scores predicts ultimate response and remission for depressed patients treated with fluoxetine or ECT.

机构信息

Department of Health-Business Administration, Fooyin University, Kaohsiung, Taiwan.

Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.

出版信息

J Affect Disord. 2019 Feb 15;245:91-97. doi: 10.1016/j.jad.2018.10.105. Epub 2018 Oct 17.

DOI:10.1016/j.jad.2018.10.105

PMID:30368075

Abstract

BACKGROUND

HAMD-6 is derived from the 17-item Hamilton Rating Scale for Depression (HAMD-17).We explore whether HAMD-6 is a reliable, valid, and sensitive to change measure, and whether early improvement using HAMD-6 can predict ultimate response/remission for inpatients with major depressive disorder (MDD) receiving either fluoxetine or electroconvulsive therapy (ECT).

METHODS

Data were from 2 trials for 126 MDD inpatients receiving fluoxetine, and 116 inpatients receiving ECT. Internal consistency, validity, and sensitivity to change using HAMD-17 and HAMD-6 at each assessment were examined and compared. Early improvement was defined as an at least 20% reduction of HAMD-17 or HAMD-6 scores at week 2 for patients receiving fluoxetine, or after 6 treatments for patients receiving ECT. Response was defined as ≥ 50% HAMD-17 score improvement from baseline, and remission was defined as a total HAMD-17 score of ≤ 7 at endpoint. Receiver operating characteristic analysis was used to determine which rating scale had better discriminative capacity.

RESULTS

HAMD-6 is a reliable, valid, and sensitive to change measure. Early improvement using HAMD-6 had comparable predictive values with that of HAMD-17 for response/remission for patients receiving either fluoxetine or ECT.

LIMITATIONS

Samples were taken from 2 open-label trials with limited sample sizes.

CONCLUSIONS

HAMD-6 is a clinically useful measure. Those patients without early improvement, however, have a minimal chance of reaching ultimate response/remission, regardless of whether HAMD-17 or HAMD-6 was use.

摘要

背景

HAMD-6 源自 17 项汉密尔顿抑郁量表（HAMD-17）。我们探索 HAMD-6 是否是一种可靠、有效的、能够敏感地反映变化的测量工具，以及在接受氟西汀或电抽搐治疗的重度抑郁症（MDD）住院患者中，使用 HAMD-6 早期改善是否可以预测最终的反应/缓解。

方法

数据来自氟西汀治疗的 126 例 MDD 住院患者和电抽搐治疗的 116 例住院患者的 2 项试验。分别使用 HAMD-17 和 HAMD-6 在每个评估点评估和比较内部一致性、有效性和对变化的敏感性。对于接受氟西汀的患者，将 HAMD-17 或 HAMD-6 评分在第 2 周至少降低 20%，或对于接受电抽搐治疗的患者，在第 6 次治疗后，定义为早期改善。反应定义为 HAMD-17 评分从基线改善≥50%，缓解定义为终点时 HAMD-17 总分≤7。使用受试者工作特征分析确定哪种评分量表具有更好的判别能力。