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[阿根廷难治性抑郁症:TRAL研究的纵向分析结果]

[Treatment-Resistant Depression in Argentina: results from a longitudinal analysis of the TRAL Study].

作者信息

Lupo Christian, García Bonetto Gerardo, Corral Ricardo Marcelo, Vilapriño Duprat Manuel, Alessandria Hernán, Kanevsky Gabriela, Perocco Sergio

机构信息

Médica psiquiatra; Directora CIAP, Rosario, Provincia de Santa Fe, Argentina.

Médico especialista en Psiquiatría, Instituto Médico DAMIC - Hospital Neuropsiquiátrico Provincia de Córdoba, Argentina.

出版信息

Vertex. 2023 Oct 10;34(161, jul.-sept.):32-44. doi: 10.53680/vertex.v34i161.484.

DOI:10.53680/vertex.v34i161.484
PMID:37819065
Abstract

Literature concerning patients with Treatment-Resistant Depression (TRD) treatment response and patient report outcomes (PROs) -such as QoL or disability- in Argentina is scarce. In the scope of the Treatment-Resistant Depression in America Latina (TRAL) study which previous results highlighted the burden of TRD compared to non-TRD patients as well as essential epidemiological data in the region, this paper reports on the outcomes of Standard-of-Care (SOC) over a 1-year follow-up of TRD patients in the subsample for Argentina. From a sample of 220 MDD patients identified in 5 sites in Argentina, 72 patients were diagnosed with TRD. Exclusion criteria included patients with psychosis, schizophrenia, bipolar disorder, schizoaffective disorder, dementia, with severe chemical dependence or currently participating in another clinical trial. MADRS, PHQ-9 and PROs (EQ-5D and SDS) were used as outcomes. Patients’ mean age was 54.7 years and 70.3% of the patients were female. Around 61% of the patients achieved a response (reduction of MADRS score ≥ 50%), but over 33% did not achieve a remission (MADRS total score ≤12). Almost 67% of the patients still felt anxious/depressed at the end of the study (EQ-5D), while disruption affected patients in diverse areas -71% in work/school, 69.7% in social life/leisure and 66.6% in their family life/personal responsibilities. The burden of TRD is significant in Argentina, and more effort should be put in the implementation of treatment protocols with better outcomes.

摘要

在阿根廷,关于难治性抑郁症(TRD)患者治疗反应以及患者报告结局(PROs)(如生活质量或残疾情况)的文献较少。在拉丁美洲难治性抑郁症(TRAL)研究范围内,此前的研究结果突出了TRD患者相较于非TRD患者的负担以及该地区的基本流行病学数据,本文报告了阿根廷子样本中TRD患者接受1年标准治疗(SOC)后的结局。在阿根廷5个地点确定的220例重度抑郁症(MDD)患者样本中,72例被诊断为TRD。排除标准包括患有精神病、精神分裂症、双相情感障碍、分裂情感性障碍、痴呆、有严重化学物质依赖或目前正在参与另一项临床试验的患者。使用蒙哥马利-艾森伯格抑郁评定量表(MADRS)、患者健康问卷-9(PHQ-9)和PROs(欧洲五维度健康量表(EQ-5D)和抑郁自评量表(SDS))作为结局指标。患者的平均年龄为54.7岁,70.3%的患者为女性。约61%的患者实现了反应(MADRS评分降低≥50%),但超过33%的患者未实现缓解(MADRS总分≤12)。在研究结束时,近67%的患者仍感到焦虑/抑郁(EQ-5D),而功能障碍在不同领域影响着患者——工作/学习方面为71%,社交生活/休闲方面为69.7%,家庭生活/个人责任方面为66.6%。在阿根廷,TRD的负担很重,应加大力度实施具有更好结局的治疗方案。

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