Treatment of consecutive episodes of major depression in the elderly.
Treatment of consecutive episodes of major depression in the elderly.
复制标题
治疗老年人连续发作的重度抑郁症。
DOI：
10.1176/ajp.151.12.1740
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发表时间：
1994
期刊：
影响因子：
--
通讯作者：
Houck,PR
中科院分区：
文献类型：
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作者：
Reynolds3rd,CF;Frank,E;Perel,JM;Miller,MD;Cornes,C;Rifai,AH;Pollock,BG;Mazumdar,S;George,CJ;Houck,PR
目的本研究的目的是确定连续治疗复发性单极重抑郁症发作的老年患者的治疗结果。方法研究对象为32例“年轻”老年复发性单极抑郁症患者（平均年龄66.8岁，SD= 5.1），连续两次接受治疗的重度抑郁症发作。在开放式试验中，用去甲替林和人际心理治疗联合治疗指数和随后的重度抑郁症发作。通过非参数统计和比例风险模型的生存分析比较指数和随后发作的缓解率。结果在完成后续发作治疗的30例患者中，27例（90%）在两次连续治疗中均获得稳定的症状缓解，而3例（10%）没有。27例对治疗有反应的患者中，有22例（81%）在随后的发作中比在第一次发作中缓解的时间更短。采用比例风险模型的生存分析发现，在指数缓解和随后发作的时间上存在显著差异（32对观察）。结论在本研究组中，80%以上的年轻老年人单极重抑郁症复发患者采用类似于治疗指数发作的药物治疗和心理治疗相结合的方法成功缓解。连续治疗发作的缓解率和缓解时间与1989年Kupfer等人报道的一组复发性抑郁症中年患者相当。因此，复发性抑郁症在年轻的老年人中似乎和在中年患者中一样是可治疗的。
ObjectiveThe purpose of this study was to determine treatment outcome in elderly patients with consecutively treated episodes of recurrent unipolar major depression.MethodSubjects were 32" young" elderly patients with recurrent unipolar depression (mean age= 66.8 years, SD= 5.1) and with two consecutively treated episodes of major depression. Both index and subsequent episodes of major depression were treated in open trial with combined nortriptyline and interpersonal psychotherapy. Rates of remission in index and subsequent episodes were compared by using nonparametric statistics and survival analysis with proportional hazards modeling.ResultsOf 30 patients who completed treatment of the subsequent episode, 27 (90%) achieved stable remission of symptoms in both consecutively treated episodes, whereas three patients (10%) did not. Twenty-two (81%) of 27 patients who responded to treatment had a shorter time to remission in treatment of the subsequent episode than in the index episode. Survival analysis with proportional hazards modeling detected a significant difference in time to remission of the index and subsequent episodes (32 paired observations).ConclusionsIn this research study group, recurrent episodes of unipolar major depression in the young elderly were successfully treated to remission in over 80% of patients by using combined pharmacotherapy and psychotherapy similar to that employed in treatment of the index episode. Remission rate and time to remission in consecutively treated episodes were comparable to those in a group of midlife patients with recurrent depression reported by Kupfer et al. in 1989. Thus, recurrent depressive disorder appears to be as treatable in the young elderly as it is in midlife patients.