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中国不同年龄组和教育水平的抑郁患者中急性治疗残留抑郁症状和功能障碍:一项前瞻性、多中心、随机研究。

Acute treatment residual depression symptoms and functional impairment among depressive patients of different age groups and education levels in China: A prospective, multicenter, randomized study.

机构信息

Department of Psychiatry, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.

The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.

出版信息

Brain Behav. 2024 Sep;14(9):e70024. doi: 10.1002/brb3.70024.

Abstract

OBJECTIVE

A prospective, multicenter, randomized study evaluated the efficacy of major depressive disorder (MDD) patients after 2-3 months of acute treatment based on the dual factors of education and age.

METHODS

This study classified the included patients into four groups using two classification parameters: age (≤45 years, vs. >45 years) and education years (≤12 vs. >12). We analyzed age, gender, marital status, personal income, depression onset history, medication use, and follow-up across various groups. We evaluated residual somatic symptoms and social functioning in depression patients was conducted using the 16-item Quick Inventory of Depressive Symptomatology Self-report (QIDS-SR16), the Patient Health Questionnaire-15 (PHQ15), and the Sheehan Disability Scale (SDS).

RESULTS

In China, 16 hospitals, 553 depression patients, and 428 fulfilled the inclusion criteria. Baseline patient data revealed significant differences among the different age groups in gender, marital status, income, first onset age, physical illness, combination of antipsychotics, and benzodiazepines use (all p < .05). Statistically significant differences were observed in overall comparisons among the four groups, encompassing the QIDS-SR16 score, PHQ15 score, and various SDS parameters (all p < .05). However, no statistically significant differences (all p > .05) were found in residual somatic symptoms and social functioning parameters between different education levels (≤12 years vs. >12 years) at baseline, 3 months, and 6 months, based on total scores on the scale. Repeated measures mixed model indicates that the QIDS-SR16 assessment indicates statistical differences among various marital statuses, income levels, medical histories, and antipsychotic medication use (p < .05). Furthermore, PHQ-15 and SDS assessments reveal statistical differences between single and married/cohabiting statuses, physical comorbidities, 3 and 6 months follow-ups compared to baseline (p < .05).

CONCLUSION

This study indicates that compared to depressive patients >45 years old, those ≤45 years old often exhibit more residual depression, somatic symptoms, and severe social functional impairment; patients' education levels less influence this trend.

摘要

目的

一项前瞻性、多中心、随机研究评估了基于教育和年龄双重因素的 2-3 个月急性治疗后重度抑郁症(MDD)患者的疗效。

方法

本研究使用两个分类参数将纳入的患者分为四组:年龄(≤45 岁,>45 岁)和受教育年限(≤12 年,>12 年)。我们分析了年龄、性别、婚姻状况、个人收入、抑郁发病史、用药情况和不同组别的随访情况。我们使用 16 项抑郁症状自评快速清单(QIDS-SR16)、患者健康问卷-15(PHQ15)和 Sheehan 残疾量表(SDS)评估抑郁患者的残留躯体症状和社会功能。

结果

在中国,有 16 家医院,553 名抑郁症患者和 428 名符合纳入标准的患者。基线患者数据显示,不同年龄组在性别、婚姻状况、收入、首发年龄、躯体疾病、抗精神病药物联合使用和苯二氮䓬类药物使用方面存在显著差异(均 P<0.05)。在四组之间的总体比较中观察到显著差异,包括 QIDS-SR16 评分、PHQ15 评分和各种 SDS 参数(均 P<0.05)。然而,在基线、3 个月和 6 个月时,根据量表总分,不同教育水平(≤12 年与>12 年)之间在残留躯体症状和社会功能参数方面没有发现统计学差异(均 P>0.05)。重复测量混合模型表明,QIDS-SR16 评估表明在各种婚姻状况、收入水平、病史和抗精神病药物使用方面存在统计学差异(P<0.05)。此外,PHQ-15 和 SDS 评估显示在单身和已婚/同居状态、躯体合并症、3 个月和 6 个月随访与基线之间存在统计学差异(P<0.05)。

结论

本研究表明,与 45 岁以上的抑郁患者相比,≤45 岁的患者往往表现出更多的残留抑郁、躯体症状和严重的社会功能障碍;患者的教育水平对这种趋势影响较小。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2307/11391025/afa8e5d20741/BRB3-14-e70024-g006.jpg

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