Corral Ricardo, Alessandria Hernan, Agudelo Baena Lina María, Ferro Eugenio, Duque Xochitl, Quarantini Lucas, Caldieraro Marco Antonio, Cabrera Patricia, Kanevsky Gabriela
Fundación para el Estudio y Tratamiento de las Enfermedades Mentales, Buenos Aires, Argentina.
Clinica Privada de Salud Mental Santa Teresa de Avila, Buenos Aires, Argentina.
Front Psychiatry. 2022 Mar 2;13:812938. doi: 10.3389/fpsyt.2022.812938. eCollection 2022.
A large proportion of patients with major depressive disorder (MDD) have treatment-resistant depression (TRD). The TRAL study examines the impact of TRD on suicidality and health-related quality of life (HRQoL) among MDD patients in 4 Latin American countries.
In this multicenter, prospective, observational study, MDD patients were recruited from 33 sites in Mexico, Colombia, Brazil, and Argentina. Patients were assessed for TRD, defined as failure to respond to ≥2 antidepressant medications of adequate dose and duration. Other assessments included current disease status, Mini International Neuropsychiatric Interview (MINI), Columbia-Suicide Severity Rating Scale (C-SSRS), 5 Level EQ-5D (EQ-5D-5L), Patient Health Questionnaire-9 (PHQ-9), and Sheehan Disability Scale (SDS).
1,475 MDD patients were included in the analysis (mean age, 45.6 years; 78% women), and 429 met criteria for TRD. Thoughts of suicide and suicide attempts were more common among TRD patients (38.7%) compared with non-TRD patients (24.9%; < 0.0001), according to the current disease status questionnaire. The C-SSRS showed that lifetime suicidal behavior was significantly more common among TRD patients than non-TRD patients (13.8 vs. 10.0%; = 0.0384). Compared with non-TRD patients, TRD patients showed significantly greater adverse impacts on QoL (EQ-5D-5L), more severe depression (PHQ-9), and greater functional impairment (SDS).
TRD patients in clinical sites from Mexico, Colombia, Brazil, and Argentina were more likely to experience suicidality and negative effects on HRQoL than non-TRD patients.
很大一部分重度抑郁症（MDD）患者患有难治性抑郁症（TRD）。TRAL研究调查了TRD对4个拉丁美洲国家MDD患者自杀倾向和健康相关生活质量（HRQoL）的影响。
在这项多中心、前瞻性、观察性研究中，从墨西哥、哥伦比亚、巴西和阿根廷的33个地点招募了MDD患者。对患者进行TRD评估，TRD定义为对≥2种足够剂量和疗程的抗抑郁药物治疗无反应。其他评估包括当前疾病状态、迷你国际神经精神病学访谈（MINI）、哥伦比亚自杀严重程度评定量表（C-SSRS）、5级EQ-5D（EQ-5D-5L）、患者健康问卷-9（PHQ-9）和希恩残疾量表（SDS）。
1475例MDD患者纳入分析（平均年龄45.6岁；78%为女性），429例符合TRD标准。根据当前疾病状态问卷，TRD患者（38.7%）的自杀念头和自杀未遂情况比非TRD患者（24.9%；P<0.0001）更为常见。C-SSRS显示，TRD患者一生中的自杀行为明显比非TRD患者更为常见（13.8%对10.0%；P=0.0384）。与非TRD患者相比，TRD患者对生活质量（EQ-5D-5L）的负面影响更大，抑郁更严重（PHQ-9），功能损害更严重（SDS）。
来自墨西哥、哥伦比亚、巴西和阿根廷临床机构的TRD患者比非TRD患者更易出现自杀倾向和对HRQoL产生负面影响。
