儿童和青少年的治疗抵抗性抑郁症。

Treatment-resistant depression in children and adolescents.

机构信息

Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.

Department of Psychiatry, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.

出版信息

Prog Brain Res. 2023;281:1-24. doi: 10.1016/bs.pbr.2023.03.004. Epub 2023 Jun 9.

DOI:10.1016/bs.pbr.2023.03.004

PMID:37806711

Abstract

Major depressive disorder (MDD) in children and adolescents is a significant health problem, causing profound impairments in social, academic, and family functioning and substantial morbidity and mortality. Up to 15% of children and adolescents suffer from MDD, and a proportion, around 30 to 40% of them, failed to respond to initial selective serotonin reuptake inhibitor (SSRI) treatment. The only evidence-based recommendation is medication switching to another SSRI and augmentation with cognitive behavioral therapy. Newly developing treatment, including ketamine, transcranial magnetic stimulation, psychotherapy other than cognitive behavioral therapy, and combined pharmacotherapy with other interventions, requires further longitudinal controlled trials regarding efficacy and safety in this vulnerable population.

摘要

儿童和青少年的重度抑郁症（MDD）是一个严重的健康问题，会导致社交、学业和家庭功能严重受损，发病率和死亡率高。多达 15%的儿童和青少年患有 MDD，其中约 30%至 40%的患者对初始选择性 5-羟色胺再摄取抑制剂（SSRI）治疗没有反应。唯一基于证据的建议是药物转换为另一种 SSRI，并结合认知行为疗法进行增效治疗。新出现的治疗方法，包括氯胺酮、经颅磁刺激、除认知行为疗法以外的心理疗法，以及与其他干预措施相结合的药物治疗，需要进一步进行针对该脆弱人群的疗效和安全性的纵向对照试验。