Lapierre Y D
Acta Psychiatr Scand Suppl. 1983;308:167-70.
Classification of depression is important, as it may provide a valuable indication of which types of treatment are likely to be effective. Most traditional classification systems follow a dichotomous approach (e.g. endogenous versus exogenous, agitated versus retarded), and consideration of such systems has led to increased understanding of depression. Treatment should be tailored to individual requirements, taking into account the type of depression and the stage at which it is being treated, the patient's personality and idiosyncrasies, and the pharmacological profile of the drug. Group trials show many antidepressants to be of approximately equivalent efficacy; however, side-effect profiles differ. The advent of the second generation antidepressants provides clinicians with non-sedating drugs, often with fewer anticholinergic side-effects. Thus, improved patient compliance and better overall functioning can be expected, as sedation often hinders recovery by producing flattening and monotony of affect, and blunting of emotional involvement and responsiveness, while cholinergic blockade increases confusional states.
抑郁症的分类很重要，因为它可能为哪些类型的治疗可能有效提供有价值的指示。大多数传统分类系统采用二分法（例如，内源性与外源性、激越性与迟滞性），对这些系统的研究增进了对抑郁症的理解。治疗应根据个体需求进行调整，要考虑到抑郁症的类型、治疗阶段、患者的个性和特质以及药物的药理学特征。分组试验表明，许多抗抑郁药的疗效大致相当；然而，副作用情况有所不同。第二代抗抑郁药的出现为临床医生提供了非镇静药物，这类药物通常抗胆碱能副作用较少。因此，可以预期患者的依从性会提高，整体功能也会改善，因为镇静常常会通过使情感变得平淡和单调、削弱情感投入和反应能力来阻碍康复，而胆碱能阻滞会增加意识模糊状态。
