Möller H J, Müller H, Volz H P
Department of Psychiatry, Ludwig-Maximilians University of Munich, Germany.
Pharmacopsychiatry. 1996 Mar;29(2):57-62. doi: 10.1055/s-2007-979545.
The timing of clinical drug effects in depression can be estimated by a variety of methodological approaches, which might account for the heterogeneity of findings. We compared the patients' own ratings of the onset of antidepressant effect with onset estimations that were based on the intraindividual courses of depression as measured by the Hamilton Depression Rating Scale and a self-rating scale, the von Zerssen Adjective Mood Scale. The data of two control-group studies on brofaromine vs. imipramine were reanalyzed, the first, comprising 224 non-elderly and the second 195 elderly patients. In both studies the patients rated a significantly earlier onset of activity (means: days 12 and 16) than any other method. The means of the scale-based ratings varied between days 20 and 31 and showed a marked dependence on the response criteria selected: strict response criteria produced later onset estimations than less strict ones. Whereas the patient's own ratings indicated a significantly later onset of activity in the elderly patients, none of the scale-based measures supported this difference. The discussion focuses on the importance of methodological aspects.
抑郁症临床药物疗效的起效时间可通过多种方法来估计，这可能是研究结果存在异质性的原因。我们将患者自身对抗抑郁药起效时间的评定与基于汉密尔顿抑郁量表和自我评定量表（冯·泽尔森形容词情绪量表）所测量的个体内抑郁病程得出的起效时间估计进行了比较。对两项关于溴法罗明与丙咪嗪的对照研究数据进行了重新分析，第一项研究有224名非老年患者，第二项研究有195名老年患者。在两项研究中，患者评定的起效时间（平均：第12天和第16天）均显著早于其他任何方法。基于量表的评定均值在第20天至第31天之间变化，且明显依赖于所选择的反应标准：严格的反应标准得出的起效时间估计比不那么严格的标准更晚。虽然患者自身的评定表明老年患者的起效时间显著更晚，但基于量表的测量均未支持这一差异。讨论聚焦于方法学方面的重要性。
