Maciaszek Julian, Pawłowski Tomasz, Hadryś Tomasz, Misiak Błażej
Department of Psychiatry, Wrocław Medical University, Wrocław, Poland.
Front Psychiatry. 2023 Jun 16;14:1210289. doi: 10.3389/fpsyt.2023.1210289. eCollection 2023.
Depression is considered one of the most prevalent and burdensome mental disorders. Only 50-60% of patients respond to first-line treatment. Individuals with depression might benefit from personalized treatment, tailored to the individual needs of the patient. In this study, we aimed to explore the baseline characteristics of depressive symptoms associated with a good response to duloxetine treatment using a network analysis. Additionally, the relationship between baseline psychopathological symptoms and treatment tolerability was assessed.
The sample of 88 drug-free patients with active depressive episode, who started monotherapy with increasing doses of duloxetine were evaluated. The Hamilton Depression Rating Scale (HAM-D) was used to assess depression severity and the UKU side effect rating scale to monitor adverse drug reactions (ADRs). A network analysis that explored interactions of specific baseline depression symptoms, treatment efficacy and tolerability was performed.
The node representing duloxetine treatment efficacy was directly connected to the nodes representing the first HAM-D item ("depressed mood") (edge weight = 0.191) and duloxetine dose (edge weight = 0.144). The node representing ADRs was directly connected to only one node representing the baseline score of the HAM-D anxiety (psychic) item (edge weight = 0.263).
Our findings indicate that individuals with depression presenting greater levels of depressed mood and lower levels of anxiety symptoms might better respond to the treatment with duloxetine in terms of efficacy and tolerability.
抑郁症被认为是最常见且负担最重的精神障碍之一。只有50 - 60%的患者对一线治疗有反应。抑郁症患者可能会从根据患者个体需求量身定制的个性化治疗中获益。在本研究中，我们旨在通过网络分析探讨与度洛西汀治疗良好反应相关的抑郁症状的基线特征。此外，还评估了基线精神病理症状与治疗耐受性之间的关系。
对88例开始接受递增剂量度洛西汀单药治疗的无药物治疗史的活动性抑郁发作患者样本进行了评估。采用汉密尔顿抑郁量表（HAM-D）评估抑郁严重程度，采用UKU副作用评定量表监测药物不良反应（ADR）。进行了一项网络分析，探讨特定基线抑郁症状、治疗疗效和耐受性之间的相互作用。
代表度洛西汀治疗疗效的节点直接与代表HAM-D首个项目（“情绪低落”）的节点相连（边权重 = 0.191）以及与度洛西汀剂量相连（边权重 = 0.144）。代表ADR的节点仅直接与代表HAM-D焦虑（精神性）项目基线评分的一个节点相连（边权重 = 0.263）。
我们的研究结果表明，情绪低落程度较高且焦虑症状水平较低的抑郁症患者在疗效和耐受性方面可能对度洛西汀治疗反应更好。
