Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York.
Charité Universitätsmedizin, Berlin, Germany.
J Clin Psychiatry. 2022 Sep 7;83(5):LU21112AH3. doi: 10.4088/JCP.LU21112AH3.
Outcome measures in major depressive disorder have traditionally focused on characteristic symptoms included in the DSM-5 definition of major depressive disorder (MDD): depressed mood, lack of interest or pleasure in activities, fatigue, guilt, and change in weight/appetite. Addressing these symptoms is clearly a treatment priority, especially in the acute stages of the treatment process. However, patients express that, beyond symptom relief, they have additional goals: restoration of functioning and of the feeling that one can participate in, and engage with, their own life. Life engagement encompasses aspects of life experience relating to cognition (including cognition colored by emotion), vitality, motivation and reward, and the ability to feel pleasure. In a recent roundtable meeting, a panel of 5 experts discussed life engagement and its relationship to symptoms and functioning in patients with major depressive disorder and schizophrenia. This Academic Highlights, part 3 in a series, summarizes the experts' discussion of how life engagement can be integrated into patient-centered discussions of treatment goals, as well as how it can inform treatment selection in for those with MDD.
在重度抑郁症的疗效评估中，传统上主要关注 DSM-5 中对重度抑郁症的定义所包含的特征性症状，包括：情绪低落、对活动缺乏兴趣或愉悦感、疲劳、内疚感以及体重/食欲变化。解决这些症状显然是治疗的首要任务，尤其是在治疗过程的急性阶段。然而，患者表示，除了缓解症状之外，他们还有其他目标：恢复功能以及一种能够参与并投入到自己生活中的感觉。生活参与度涵盖了与认知（包括受情绪影响的认知）、活力、动机和奖励以及感受快乐的能力相关的生活体验方面。在最近的一次小组讨论会上，一个由 5 名专家组成的小组讨论了生活参与度以及它与重度抑郁症和精神分裂症患者的症状和功能之间的关系。这篇学术要点是系列文章的第 3 部分，总结了专家们关于如何将生活参与度纳入以患者为中心的治疗目标讨论，以及如何为那些患有 MDD 的患者提供治疗选择信息的讨论。
