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抗抑郁药与健康相关的生活质量:如何用批判的眼光检查一篇“热门”研究论文的读者指南。

Antidepressant Drugs and Health-Related Quality of Life: A Reader's Guide on How to Examine a "Viral" Research Paper With a Critical Eye.

机构信息

Department of Clinical Psychopharmacology and Neurotoxicology, National Institute of Mental Health and Neurosciences, Bangalore, India (

出版信息

J Clin Psychiatry. 2022 May 25;83(3):22f14527. doi: 10.4088/JCP.22f14527.

Abstract

Antidepressant drugs are effective against depression. They also improve subjective and functional outcomes such as disability, work functioning, social functioning, well-being, and health-related quality of life (HRQoL) in depressed patients. However, a recent large retrospective cohort study found that depressed subjects who received vs did not receive antidepressants did not differ in improvement in HRQoL, as measured using the 12-item Short Form (SF-12) Health Survey at the start and at the end of a 2-year period. The authors of the study therefore questioned the benefits of continuation of antidepressant drugs, suggesting a role for nonpharmacological interventions, instead. The study "went viral"; its findings were widely disseminated in the mass media and at medical and health care websites for physicians and for the lay public. The study, however, suffered from serious methodological shortcomings. These shortcomings are systematically explained so that readers understand how to critically read a research paper. This is important because uncritical acceptance of the findings of the study can negatively impact attitudes toward antidepressant medication among patients and health care professionals and may even result in decreased medication adherence in patients receiving antidepressant maintenance therapy.

摘要

抗抑郁药对抑郁症有效。它们还能改善残疾、工作能力、社会功能、幸福感和与健康相关的生活质量(HRQoL)等主观和功能结果,在抑郁患者中。然而,最近一项大型回顾性队列研究发现,接受与未接受抗抑郁药治疗的抑郁患者在 HRQoL 改善方面没有差异,这是通过在 2 年期间开始和结束时使用 12 项简短表格(SF-12)健康调查来衡量的。因此,研究作者质疑继续使用抗抑郁药的好处,建议采用非药物干预措施。该研究“病毒式传播”;其研究结果在大众媒体、医学和医疗保健网站上广泛传播,供医生和公众阅读。然而,该研究存在严重的方法学缺陷。这些缺点被系统地解释,以便读者了解如何批判性地阅读研究论文。这一点很重要,因为对抗抑郁药物研究结果不加批判的接受可能会对患者和医疗保健专业人员对抗抑郁药物的态度产生负面影响,甚至可能导致接受抗抑郁维持治疗的患者药物依从性下降。

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