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使用伏硫西汀治疗的在职重度抑郁症患者的焦虑症状:AtWoRC研究中与临床及治疗结果的关联

Anxiety symptoms in working patients with major depressive disorder treated with vortioxetine: associations with clinical and treatment outcomes in the AtWoRC study.

作者信息

Chokka Pratap, Ge Holly, Bougie Joanna, Ettrup Anders, Clerzius Guerline

机构信息

Grey Nuns Community Hospital, 1100 Youville Drive West, Edmonton, Alberta T6L 5X8, Canada.

Lundbeck Singapore Pte Ltd, Singapore.

出版信息

Ther Adv Psychopharmacol. 2021 May 10;11:20451253211013148. doi: 10.1177/20451253211013148. eCollection 2021.

Abstract

BACKGROUND

Anxiety symptoms are common in patients with major depressive disorder (MDD) and usually confer worse treatment outcomes. The long-term, open-label AtWoRC study in working patients with MDD treated with vortioxetine demonstrated a significant correlation between severity of anxiety symptoms and impaired work productivity. This analysis was undertaken to further explore clinical characteristics and treatment outcomes in patients with different levels of severity of anxiety symptoms at baseline.

METHODS

analysis in 199 working patients with MDD treated with vortioxetine (10-20 mg/day), stratified by Generalized Anxiety Disorder 7-item (GAD-7) score at baseline [mild/moderate anxiety (GAD-7 ⩽14),  = 83; severe anxiety (GAD-7 ⩾15),  = 116]. Associations were examined between GAD-7 and other outcome assessment scores at baseline. Observed mean changes from baseline to week 52 were compared between groups.

RESULTS

Patients with severe anxiety had significantly worse depressive and cognitive symptoms, functioning, and work productivity at baseline than those with mild/moderate anxiety, but similar cognitive performance. Statistically significant improvements from baseline were seen for all outcomes after 52 weeks of vortioxetine treatment, with no significant differences observed between the two groups after adjustment for baseline anxiety scores.

CONCLUSION

Treatment with vortioxetine was associated with long-term improvement in clinical symptoms and measures of work productivity in patients with MDD in a real-world setting, irrespective of severity of anxiety symptoms at the start of treatment.

摘要

背景

焦虑症状在重度抑郁症(MDD)患者中很常见,并且通常预示着更差的治疗结果。一项针对使用伏硫西汀治疗的在职MDD患者的长期开放性AtWoRC研究表明,焦虑症状的严重程度与工作效率受损之间存在显著相关性。本次分析旨在进一步探究基线时焦虑症状严重程度不同的患者的临床特征和治疗结果。

方法

对199例使用伏硫西汀(10 - 20毫克/天)治疗的在职MDD患者进行分析,根据基线时的广泛性焦虑障碍7项量表(GAD - 7)评分进行分层[轻度/中度焦虑(GAD - 7≤14),n = 83;重度焦虑(GAD - 7≥15),n = 116]。研究了基线时GAD - 7与其他结局评估分数之间的关联。比较了两组从基线到第52周观察到的平均变化。

结果

重度焦虑患者在基线时的抑郁和认知症状、功能及工作效率明显比轻度/中度焦虑患者差,但认知表现相似。伏硫西汀治疗52周后,所有结局指标均较基线有统计学意义的改善,在对基线焦虑评分进行调整后,两组间未观察到显著差异。

结论

在现实环境中,伏硫西汀治疗与MDD患者的临床症状长期改善及工作效率指标提高相关,无论治疗开始时焦虑症状的严重程度如何。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e08/8120527/5382fe4e7a77/10.1177_20451253211013148-fig1.jpg

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