The pharmacological treatment of delusional depression.
The pharmacological treatment of delusional depression.
复制标题
妄想性抑郁症的药物治疗。
DOI：
10.1176/ajp.142.4.430
复制
发表时间：
1985
期刊：
影响因子：
--
通讯作者：
Soloff,PH
中科院分区：
文献类型：
--
作者：
Spiker,DG;Weiss,JC;Dealy,RS;Griffin,SJ;Hanin,I;Neil,JF;Perel,JM;Rossi,AJ;Soloff,PH
METHODPotential subjects for this project were admitted to the inpatient service at our institution, where they were placed under the care of a project psychiatrist. Both men and women between the ages of 18 and 65 were accepted. At the time of admission all potential subjects had a traditional psychiatric evaluation, medical history, and physical examination. During the next 7 drug-free days, the patients received a series of routine laboratory tests, including an EEG, thyroid function tests, and any other laboratory tests indicated on the basis of their medical history or physical examination. Women of childbearing age had a pregnancy test. To be considered for the study, patients could not have any medical illness that contraindicated the use of amitriptyline or perphenazine, and women could not be pregnant. In addition, patients could not have any medical illness that affected the CNS, such as Parkinson’s disease, or be on any medication that affected the CNS, such as steroids or propranolol. One patient who had been on adequate replacement doses of thyroid medication, as determined by a normal thyroid stimulating hormone level determined at the time of admission, was kept in the study.At the end of the 7-day drug-free period patients were reinterviewed and the Schedule for Affective Disorders and Schizophrenia(SADS)(29) was completed using information from patient interviews, medical records, family members’ interviews, and clinical observations during the drug-free period. To enter the study, patients had to satisfy Research Diagnostic Criteria(RDC)(3) for a definite diagnosis of major depressive disorder, primary subtype. In addition, they had to meet the criteria for the psychotic subtype on the basis of the presence of a delusion, which was defined as a fixed belief that was clearly false, could be tested against known reality, and was not shared by the patient’s family or cultural group. Ambiguous cases were excluded. In addition, the delusion had to have a severity rating of 4 or more on the 6-point scale in the SADS that rates severity of delusions(29). Severity of depression was measured using the average of two raters’ scores on the original 17-item Hamilton Rating Scale for Depression(30). To enter the study, the patients had to have a Hamilton score of 15 or more. When patients met all the inclusion and exclusion criteria, the project was discussed with them and informed consent was obtained. The sample consisted of 36 women and 22 men; 54 subjects were white and four were black. There were
