Sampogna Gaia, Toni Claudia, Catapano Pierluigi, Rocca Bianca Della, Di Vincenzo Matteo, Luciano Mario, Fiorillo Andrea
Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy.
Curr Opin Psychiatry. 2024 Jan 1;37(1):3-8. doi: 10.1097/YCO.0000000000000903. Epub 2023 Oct 19.
Major depressive disorder (MDD) is a common and burdensome severe mental disorder, which is expected to become the leading cause of disease burden worldwide. Most patients with MDD remain untreated/undertreated. For many decades "a trial and error" approach has been adopted for selecting the best treatment plan for each individual patient, but more recently a personalized treatment approach has been proposed, by taking into account several individual and clinical factors (e.g., clinical stage, comorbidity, duration of illness). Therefore, the aim of this study is to address the most relevant innovations in the personalized treatment plan for patients with MDD.
In recent years, several pharmacological and nonpharmacological innovations have been introduced in the treatment of patients with MDD. As regards pharmacological treatments, the newly developed drugs have an innovative mechanism of action, targeting the glutamatergic systems. These drugs are highly effective in improving depressive symptoms, with a good level of safety and tolerability. As regards nonpharmacological interventions, innovations include both new strategies targeting different domains (e.g., lifestyle interventions aiming to improve the physical symptoms of depression or virtual reality) and classical interventions provided through innovative mechanisms (e.g., web-based psychotherapies and use of digital approaches). Patients globally report a good level of acceptability of these interventions.
Depression is a heterogeneous, complex and multidimensional disorder, representing one of the leading causes of disability worldwide. The final aim of the management of patients is functional recovery, which can be achieved by using personalized, integrated and recovery-oriented interventions. Several innovative pharmacological and nonpharmacological treatments are now available; interventions should be selected on the basis of the patient's needs and preferences in order to tailor the treatment, according to a shared decision-making approach.
重度抑郁症（MDD）是一种常见且负担沉重的严重精神障碍，预计将成为全球疾病负担的主要原因。大多数MDD患者仍未得到治疗或治疗不足。几十年来，一直采用“试错”方法为每位患者选择最佳治疗方案，但最近有人提出了个性化治疗方法，要考虑到几个个体和临床因素（如临床阶段、合并症、病程）。因此，本研究的目的是探讨MDD患者个性化治疗方案中最相关的创新之处。
近年来，MDD患者的治疗引入了多种药物和非药物创新。在药物治疗方面，新开发的药物具有创新的作用机制，以谷氨酸能系统为靶点。这些药物在改善抑郁症状方面非常有效，安全性和耐受性良好。在非药物干预方面，创新包括针对不同领域的新策略（如旨在改善抑郁身体症状的生活方式干预或虚拟现实）以及通过创新机制提供的经典干预（如基于网络的心理治疗和数字方法的使用）。全球患者对这些干预措施的接受度较高。
抑郁症是一种异质性、复杂且多维度的疾病，是全球致残的主要原因之一。治疗患者的最终目标是功能恢复，这可以通过使用个性化、综合且以康复为导向的干预措施来实现。现在有几种创新的药物和非药物治疗方法；应根据患者的需求和偏好选择干预措施，以便根据共同决策方法量身定制治疗方案。
