Residual symptoms in depressed patients who respond acutely to fluoxetine
Residual symptoms in depressed patients who respond acutely to fluoxetine
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DOI：
10.4088/jcp.v60n0403
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发表时间：
1999-04-01
影响因子：
5.3
通讯作者：
Fava, M
中科院分区：
文献类型：
--
作者：
Nierenberg, AA;Keefe, BR;Fava, M
工作背景：与安慰剂相比，抗抑郁药具有明确的疗效，但许多患者尽管对抗抑郁药治疗有强烈反应，但仍有残留症状。本研究的目的是评估残留症状的门诊患者谁回应急性fluoxetine.Method：215例门诊患者与DSM-III-R（SCID-P）的结构化临床访谈进行了评估与氟西汀20 mg/天，8周的公开治疗。108例（50.2%）被视为完全缓解者（最终17项汉密尔顿抑郁评定量表[HAM-D]评分≤ 7分）。计算了持续存在阈下或完全重度抑郁症症状的完全应答者的百分比。结果：在108例应答者中，19例（17.6%）无阈下或阈下SCID-P重性抑郁障碍症状，28例（25.9%）有1种症状，61例（56.5%）有2种或2种以上症状。没有统计学显着的残留症状和选定的轴I共病条件或轴IIdisorders.Conclusion总数之间的关系：不到20%的充分响应氟西汀的HAM-D标准是免费的所有SCID-P亚阈值和阈值重度抑郁症症状治疗8周后。虽然抑郁症患者受益于抗抑郁药，但大多数人仍然有一些抑郁症的症状。抗抑郁药应答者中残留症状的高患病率表明需要进一步研究，包括残留症状是否随着治疗时间的延长或氟西汀剂量的增加而减轻。其他策略，如认知行为疗法，可能需要解决残留症状。
Background: Antidepressants have unequivocal efficacy as compared with placebo, but many patients have residual symptoms despite a robust response to antidepressant therapy. The purpose of this study is to assess residual symptoms in outpatients who respond acutely to fluoxetine.Method: Two hundred and fifteen outpatients with major depressive disorder as assessed with the Structured Clinical Interview for DSM-III-R (SCID-P) were treated openly with fluoxetine 20 mg/day for 8 weeks. One hundred and eight (50.2%) were considered full responders (final 17-item Hamilton Rating Scale for Depression [HAM-D] score less than or equal to 7). Percentages of full responders who continued to have subthreshold or full major depressive disorder symptoms were calculated. The relationship beta een residual symptoms and Axis I and Axis II (assessed with SCID-II for personality disorders) comorbidity was assessed.Results: Of the 108 responders, 19 (17.6%) had no subthreshold or threshold SCID-P major depressive disorder symptoms, while 28 (25.9%) had 1 symptom, and 61 (56.5%) had 2 or more symptoms. No statistically significant relationships were found between number of residual symptoms and selected Axis I comorbid conditions or total number of Axis II disorders.Conclusion: Less than 20% of full responders to fluoxetine by HAM-D criteria were free of all SCID-P subthreshold and threshold major depressive disorder symptoms after 8 weeks of treatment. While depressed patients benefit from antidepressants, most continue to have some symptoms of depression. The high prevalence of residual symptoms among antidepressant responders suggests the need for further study including whether residual symptoms abate with longer treatment or increased dose of fluoxetine. Other strategies, such as cognitive behavioral therapy, may be needed to address residual symptoms.