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基因检测在优化复发性抑郁症患者治疗中的作用

The Contribution of Genetic Testing in Optimizing Therapy for Patients with Recurrent Depressive Disorder.

作者信息

Platona Rita Ioana, Voiță-Mekeres Florica, Tudoran Cristina, Tudoran Mariana, Enătescu Virgil Radu

机构信息

Doctoral School, University of Medicine and Pharmacy "Victor Babes" Timisoara, 300041 Timisoara, Romania.

Psychiatry Department, County Clinical Emergency Hospital of Oradea, 410169 Oradea, Romania.

出版信息

Clin Pract. 2024 Apr 23;14(3):703-717. doi: 10.3390/clinpract14030056.

Abstract

(1) Background: The aim of this study was to analyze the impact of pharmacogenetic-guided antidepressant therapy on the 12-month evolution of the intensity of depressive symptoms in patients with recurrent depressive disorder (RDD) in comparison to a control group of depressive subjects who were treated conventionally. (2) Methods: This prospective longitudinal study was conducted between 2019 and 2022, and the patients were evaluated by employing the Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A) and the Clinical Global Impressions Scale: Severity and Improvement. We followed them up at 1, 3, 6, and 12 months. (3) Results: Of the 76 patients with RDD, 37 were tested genetically (Group A) and 39 were not (Group B). Although the patients from Group A had statistically significantly more severe MDD at baseline than those from Group B ( < 0.001), by adjusting their therapy according to the genetic testing, they had a progressive and more substantial reduction in the severity of RDD symptoms [F = 74.334; η = 0.674; < 0.001], indicating a substantial association with the results provided by the genetic testing (67.4%). (4) Conclusions: In patients with RDD and a poor response to antidepressant therapy, pharmacogenetic testing allows for treatment adjustment, resulting in a constant and superior reduction in the intensity of depression and anxiety symptoms.

摘要

(1) 背景:本研究旨在分析药物遗传学指导的抗抑郁治疗对复发性抑郁症(RDD)患者抑郁症状强度12个月演变的影响,并与接受传统治疗的抑郁症对照组进行比较。(2) 方法:这项前瞻性纵向研究于2019年至2022年进行,采用汉密尔顿抑郁量表(HAM-D)、汉密尔顿焦虑量表(HAM-A)和临床总体印象量表:严重程度和改善情况对患者进行评估。我们在1、3、6和12个月时对他们进行随访。(3) 结果:在76例RDD患者中,37例进行了基因检测(A组),39例未进行(B组)。虽然A组患者在基线时的重度抑郁症在统计学上比B组患者更严重(<0.001),但通过根据基因检测调整治疗,他们的RDD症状严重程度有逐渐且更显著的降低 [F = 74.334;η = 0.674;<0.001],表明与基因检测结果有显著关联(67.4%)。(4) 结论:对于RDD且对抗抑郁治疗反应不佳的患者,药物遗传学检测有助于调整治疗,从而持续且更显著地降低抑郁和焦虑症状的强度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4284/11130888/984d500eee6d/clinpract-14-00056-g001.jpg

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