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青少年抑郁评定量表(ADRS)在异维 A 酸治疗重度痤疮青少年患者中的首次应用:皮肤科医生主动监测抑郁障碍的初步研究。

First use of the Adolescent Depression Rating Scale (ADRS) in the management of young people with severe acne treated with isotretinoin: a pilot study of an active monitoring of depressive disorders by dermatologists.

机构信息

Department of Dermatology, Grand Hôpital Est Francilien, Jossigny, France.

Service de Pharmacologie Clinique et Pharmacovigilance, Pharmacometry and Pharmacoepidemiology, Institut de Neurosciences des Systèmes, APHM/INSERM/Aix Marseille University, Marseille, France.

出版信息

Clin Exp Dermatol. 2022 Apr;47(4):709-716. doi: 10.1111/ced.15039. Epub 2021 Dec 27.

Abstract

BACKGROUND

During isotretinoin treatment, special attention is required to detect any symptom or change in the mental health of patients. The monitoring is complex for adolescents because of confounding factors such as mood changes associated with adolescence and puberty and the higher psychosocial impairment due to the acne itself.

AIM

To determine the utility of the Adolescent Depression Rating Scale (ADRS) for monitoring symptoms in adolescents before and during isotretinoin treatment in dermatology real-life practice.

METHODS

This was a national, multicentre prospective study that enrolled a random sample of dermatologists treating adolescents. An algorithm including ADRS score and its changes between consecutive visits was used. At each visit, dermatologists rated their satisfaction with ADRS and its ease of use, while patients rated the acceptability of the ADRS.

RESULTS

In total, 70 dermatologists used the algorithm for 1227 visits of 283 adolescents receiving isotretinoin. Of these 70 dermatologists, 80.8% were satisfied/very satisfied with the ADRS, 82.7% considered the use of the ADRS in clinical practice to be easy/very easy and 75% considered that the ADRS enabled them to discuss more easily the risk of depression with their patients. For the patients, acceptability of the ADRS was considered good by 93.8%.

CONCLUSIONS

The implementation of the ADRS could be valuable in dermatology practice, optimizing the monitoring of patients and the good use of isotretinoin.

摘要

背景

在异维 A 酸治疗期间,需要特别注意检测患者的心理健康出现的任何症状或变化。由于青少年时期的情绪变化和青春期、痤疮本身导致的更高的心理社会障碍等混杂因素,对青少年进行监测较为复杂。

目的

确定青少年抑郁评定量表(ADRS)在皮肤科真实实践中监测异维 A 酸治疗前和治疗期间青少年患者症状的效用。

方法

这是一项全国性的、多中心的前瞻性研究,纳入了随机抽取的治疗青少年的皮肤科医生。使用包括 ADRS 评分及其在连续就诊期间变化的算法。在每次就诊时,皮肤科医生评估他们对 ADRS 的满意度及其易用性,而患者评估 ADRS 的可接受性。

结果

共有 70 名皮肤科医生在 283 名接受异维 A 酸治疗的青少年的 1227 次就诊中使用了该算法。在这 70 名皮肤科医生中,80.8%对 ADRS 感到满意/非常满意,82.7%认为在临床实践中使用 ADRS 很容易/非常容易,75%认为 ADRS 使他们能够更轻松地与患者讨论抑郁风险。对于患者而言,93.8%认为 ADRS 的可接受性良好。

结论

ADRS 的实施可能在皮肤科实践中具有价值,可优化对患者的监测和对异维 A 酸的合理使用。

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