Dimensions in major depressive disorder and their relevance for treatment outcome.
Dimensions in major depressive disorder and their relevance for treatment outcome.
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DOI：
10.1016/j.jad.2013.10.020
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发表时间：
2014-02
影响因子：
6.6
通讯作者：
Claes, Stephan
中科院分区：
文献类型：
--
作者：
Vrieze, Elske;Demyttenaere, Koen;Bruffaerts, Ronny;Hermans, Dirk;Pizzagalli, Diego A.;Sienaert, Pascal;Hompes, Titia;de Boer, Peter;Schmidt, Mark;Claes, Stephan
重度抑郁障碍(MDD)是一种异质性疾病。更多同质的心理(病理)逻辑维度将促进MDD的研究和临床实践。这项研究的第一个目的是在抑郁症患者的广泛的精神病理学评估中找到潜在的维度。其次，我们的目的是检验这些维度如何预测MDD的进程。对75例MDD住院患者的10个精神病理变量进行了评估。因子和回归分析评估了治疗8周后精神病理因素与抑郁严重程度和结果之间的假定关系。建立了代表精神运动改变、快感缺乏和负性影响因素的3因素模型(特征值：54.4%)。快感缺乏和负性影响预测抑郁严重程度(R2=0.37，F=20.86，p<；0.0001)。快感缺乏预示无反应(OR 6.00，CI 1.46~24.59)，负性情绪(OR 5.69，CI 1.19~27.20)和快感缺失预示无缓解(OR 9.28，CI 1.85~46.51)。这项研究的样本量相对较小，限制了分析中包括的变量数量。结果证实精神运动改变、快感缺乏和负性情绪是MDD的关键维度，其中两个维度与治疗结果有关。
Major Depressive Disorder (MDD) is a heterogeneous disease. More homogeneous psycho(patho)logical dimensions would facilitate MDD research as well as clinical practice. The first aim of this study was to find potential dimensions within a broad psychopathological assessment in depressed patients. Secondly, we aimed at examining how these dimensions predicted course in MDD. Ten psychopathological variables were assessed in 75 MDD inpatients. Factor and regression analyses assessed putative relations between psychopathological factors and depression severity and outcome after 8 weeks of treatment. A 3 factor model (eigenvalue: 54.4%) was found, representing a psychomotor change, anhedonia and negative affect factor. Anhedonia and negative affect predicted depression severity (R2=0.37, F=20.86, p<0.0001). Anhedonia predicted non-response (OR 6.00, CI 1.46–24.59) and both negative affect (OR 5.69, CI 1.19–27.20) and anhedonia predicted non-remission (OR 9.28, CI 1.85–46.51). The sample size of the study was relatively modest, limiting the number of variables included in the analysis. Results confirm that psychomotor change, anhedonia and negative affect are key MDD dimensions, two of which are related to treatment outcome.
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