Symptom improvement and residual symptoms during acute antidepressant treatment in pediatric major depressive disorder.
Symptom improvement and residual symptoms during acute antidepressant treatment in pediatric major depressive disorder.
复制标题
小儿重度抑郁症急性抗抑郁治疗期间的症状改善和残留症状。
DOI：
10.1089/cap.2009.0116
复制
发表时间：
2010
影响因子：
1.9
通讯作者：
Kennard,BetsyD
中科院分区：
文献类型：
--
作者：
Tao,Rongrong;Emslie,GrahamJ;Mayes,TarynL;Nakonezny,PaulA;Kennard,BetsyD
目的：了解特定抑郁症状改善的时机将有助于临床医生为患者做好准备，改善治疗结果，而了解哪些抑郁症状可能出现延迟改善将有助于临床医生在治疗早期提供额外的干预措施。在一项前瞻性开放标签氟西汀研究中，我们调查了急性治疗期间抑郁症状改善的时间，并确定了抑郁症青年在急性治疗4、8和12周后常见的残留症状。方法：168名7-18岁的儿童和青少年接受氟西汀治疗12周，这些儿童和青少年最初被诊断为严重抑郁障碍(MDD)。使用儿童情感障碍和精神分裂症量表对青少年进行了评估。结果：所有的抑郁症状都得到了改善，尤其是在急性治疗的前4周。47%的汇款人报告在12周后至少有一种残留症状，最常见的残留症状是学习成绩下降、失眠和易怒。结论：在12周的急性治疗结束时，残留症状很常见，即使在汇款人中也是如此。临床医生有必要监测症状的改善，并有可能为更具抵抗力的症状提供额外的干预措施，如失眠和学习成绩。
Objective:Knowing the timing of specific depressive symptom improvement will enable clinicians to prepare their patients well and improve treatment outcome, whereas recognizing which depressive symptoms may show delayed improvement will help clinicians to provide additional interventions early in treatment. In a prospective open-label fluoxetine study, we investigated the timing of depressive symptom improvement during acute treatment, and identified common remaining symptoms following 4, 8, and 12 weeks of acute treatment in depressed youths.Method:A total of 168 children and adolescents, aged 7–18 years, with primary diagnoses of major depressive disorder (MDD) received 12 weeks of fluoxetine treatment. Youths were evaluated using the Kiddie Schedule for Affective Disorders and Schizophrenia. The outcome measure included the Children's Depression Rating Scale–Revised.Results:All depressive symptoms improved, particularly during the first 4 weeks of acute treatment. Forty-seven percent of remitters reported at least one residual symptom following 12 weeks, with most common residual symptoms being impaired school performance, insomnia, and irritability.Conclusions:Residual symptoms are common, even among remitters, at the end of 12 weeks of acute treatment. There is a need for clinicians to monitor symptom improvement and potentially provide additional interventions for the more resistant symptoms, such as insomnia and school performance.