Correlates and outcomes of depressed out-patients with greater and fewer anxious symptoms: a CO-MED report
Correlates and outcomes of depressed out-patients with greater and fewer anxious symptoms: a CO-MED report
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DOI：
10.1017/s1461145711001660
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发表时间：
2012-11-01
影响因子：
4.8
通讯作者：
Fava, Maurizio
中科院分区：
文献类型：
--
作者：
Chan, Herng Nieng;Rush, A. John;Fava, Maurizio
本文的目的是确定是否存在更多或更少的焦虑症状特征，在基线时，与其他临床特征和治疗结果的门诊抑郁症（MDD）患者。这项单盲、随机试验入组了665例MDD门诊患者，比较了两种抗抑郁药物组合对艾司西酞普兰在12周急性治疗和随访（共28周）后的疗效。使用基线17项汉密尔顿抑郁评定量表的焦虑/躯体化子量表，将样本分为焦虑特征更强（与更少）的样本。比较两组的基线社会人口统计学和临床特征、治疗特征和结局。总体而言，74.7%的参与者达到了“焦虑特征”的门槛。他们更可能是女性，有其他并发的焦虑症，更严重的抑郁症，更嗜睡和神经质的功能和较差的认知和身体功能，生活质量和工作和社会适应。在急性治疗中，具有焦虑特征的参与者接受了相对较高剂量的米氮平和文拉法辛，并报告了更多的副作用。有和没有焦虑特征的组在治疗结果和副作用负担方面没有差异。尽管与不同的临床特征相关，但基线焦虑特征在预测急性治疗结局或差异治疗反应方面没有临床意义。
The objective of this paper was to determine whether the presence of more vs. fewer anxious symptom features, at baseline, are associated with other clinical features and treatment outcomes in out-patients with major depressive disorder (MDD). This single-blind, randomized trial enrolled 665 MDD outpatients to compare the efficacy of two antidepressant medication combinations against escitalopram after 12-wk acute treatment and follow-up (total 28 wk). The sample was divided into those with greater (vs. fewer) anxiety features using the anxiety/somatization subscale of the baseline 17-item Hamilton Rating Scale for Depression. Baseline sociodemographic and clinical features, treatment features and outcomes compared these two groups. Overall, 74.7% of participants met the threshold for 'anxious features'. They were more likely to be female, have other concurrent anxiety disorders, more severe depression, more lethargic and melancholic features and poorer cognitive and physical functioning, quality of life and work and social adjustment. In acute treatment, participants with anxious features received comparatively higher doses of mirtazapine and venlafaxine and reported more side-effects. The groups with and without anxious features did not differ in treatment outcomes and side-effect burden. Despite being associated with a distinct clinical profile, baseline anxious features were not clinically useful in predicting acute treatment outcomes or differential treatment response.