Pastuszak Michał, Cubała Wiesław Jerzy, Kwaśny Aleksander, Mechlińska Agnieszka
Department of Psychiatry, Faculty of Medicine, Medical University of Gdańsk, 80-214 Gdańsk, Poland.
J Pers Med. 2024 Aug 4;14(8):828. doi: 10.3390/jpm14080828.
Residual symptoms are prevalent in major depressive disorder (MDD), encompassing a wide spectrum of symptoms such as sleep disturbances, changes in weight and appetite, cognitive impairment, and anxiety. These symptoms consistently impair daily functioning, diminish quality of life, and forecast disease relapse. Despite their clinical significance, residual symptoms lack a unified definition, potentially leading to confusion with treatment-emergent symptoms and ambiguity across studies, thereby hindering the generalizability of research findings. While some research identifies insomnia and mood disturbances as critical indicators, other studies emphasize different symptoms or find no significant correlation. Inconsistencies in defining residual symptoms, as well as methodological differences across studies, contribute to these conflicting results. While clinicians focus on alleviating negative symptoms to improve functional status, patients often prioritize achieving positive affect and overall well-being as essential components of successful treatment. It necessitates a comprehensive approach to patient care in depression. This review explores the phenomenon of residual symptoms in MDD, focusing on the ambiguity in definitions, clinical characteristics, and their impact on long-term outcomes. The lack of a standardized regulatory or academic definition for residual symptoms leads to varied interpretations among clinicians, underscoring the need for standardized terminology to guide effective treatment strategies and future research.
残留症状在重度抑郁症(MDD)中很常见,包括一系列症状,如睡眠障碍、体重和食欲变化、认知障碍以及焦虑。这些症状持续损害日常功能,降低生活质量,并预示疾病复发。尽管其具有临床意义,但残留症状缺乏统一的定义,这可能导致与治疗中出现的症状混淆,以及不同研究之间的定义模糊,从而阻碍研究结果的推广。虽然一些研究将失眠和情绪障碍确定为关键指标,但其他研究则强调不同的症状,或者未发现显著相关性。残留症状定义的不一致以及不同研究的方法差异导致了这些相互矛盾的结果。虽然临床医生专注于减轻负面症状以改善功能状态,但患者通常将实现积极情绪和整体幸福感作为成功治疗的重要组成部分。这就需要对抑郁症患者的护理采取综合方法。本综述探讨了MDD中残留症状的现象,重点关注定义的模糊性、临床特征及其对长期预后的影响。残留症状缺乏标准化的监管或学术定义,导致临床医生之间存在不同的解释,这凸显了需要标准化术语来指导有效的治疗策略和未来研究。