Faculty of Medicine and University Clinical Centre of Serbia, University of Belgrade, Belgrade, Serbia.
Ss. Cyril and Methodius University, Skopje, North Macedonia.
PLoS One. 2024 Jan 2;19(1):e0295754. doi: 10.1371/journal.pone.0295754. eCollection 2024.
This paper aims to examine the frequency and significance of diagnostic comorbidity of psychiatric disorders and somatic diseases in a sample of patients with depression as well as present current psychopharmacological treatment of the patients in the sample.
The subjects in this study sample were 489 patients from the four Western Balkan countries with current primary diagnosis of major depression according to ICD 10. Comorbid psychiatric disorders and non-psychiatric illnesses were noted according to ICD 10 criteria during the diagnostic interview and analysed later. Additionally, the pharmacological treatment (existing and newly introduced) for each patient was noted and analysed later.
At least one comorbid psychiatric disorder was present in 72.5% of patients. The most frequent were anxiety disorders (53.6%), specifically generalized anxiety disorder (20.2%); non-organic sleep disorders (50.7%), specifically insomnia (48.4%); and sexual dysfunctions (21.4%), specifically lack of sexual desire (20.2%). Comorbidity with any non-psychiatric illness was present in 80.3% of patients. The most frequent were circulatory system diseases (55.9%), specifically hypertension (45.9%); endocrine, nutritional and metabolic disorders (51.3%), specifically hyperlipidaemia (24.0%); and other non-psychiatric disorders (60.7%), specifically low back pain (22.7%). All patients received pharmacological treatment with different medications. Most patients received monotherapy or combination therapy of antidepressants, anxiolytics, antipsychotics and antiepileptics. The most frequently used antidepressants were escitalopram, sertraline, and duloxetine. The most frequently used anxiolytics were alprazolam and diazepam, the most used antiepileptic was pregabalin, and the most used antipsychotics were olanzapine, quetiapine, and aripiprazole.
The results of the study confirm the results of previous research studies about the high prevalence of psychiatric and non-psychiatric comorbidities in patients with depression that were conducted in the past. It would be important if future studies could prove the importance of those comorbidities on clinical severity, choice of treatment, and its outcome in patients with depression.
本研究旨在调查患有抑郁症的患者中精神障碍和躯体疾病的诊断共病的频率和意义，并介绍该研究样本中当前的精神药理学治疗方法。
本研究的受试者为来自四个西巴尔干国家的 489 名患者，他们目前根据 ICD-10 被诊断为患有重度抑郁症。在诊断性访谈中根据 ICD-10 标准记录共病性精神障碍和非精神疾病，并在之后进行分析。此外，还记录并分析了每位患者的（现有和新引入的）药物治疗方法。
至少存在一种共病性精神障碍的患者占 72.5%。最常见的是焦虑障碍（53.6%），尤其是广泛性焦虑障碍（20.2%）；非器质性睡眠障碍（50.7%），尤其是失眠（48.4%）；以及性功能障碍（21.4%），尤其是性欲缺乏（20.2%）。存在任何非精神疾病共病的患者占 80.3%。最常见的是循环系统疾病（55.9%），尤其是高血压（45.9%）；内分泌、营养和代谢紊乱（51.3%），尤其是高脂血症（24.0%）；以及其他非精神疾病（60.7%），尤其是腰痛（22.7%）。所有患者均接受了不同药物的药物治疗。大多数患者接受了抗抑郁药、抗焦虑药、抗精神病药和抗癫痫药的单药或联合治疗。最常使用的抗抑郁药是艾司西酞普兰、舍曲林和度洛西汀。最常使用的抗焦虑药是阿普唑仑和地西泮，最常使用的抗癫痫药是普瑞巴林，最常使用的抗精神病药是奥氮平、喹硫平和阿立哌唑。
本研究结果证实了过去进行的关于抑郁症患者中精神障碍和非精神障碍共病发生率较高的研究结果。如果未来的研究能够证明这些共病对临床严重程度、治疗选择及其对抑郁症患者的预后的重要性，将是非常重要的。
