Recall accuracy for the symptoms of a major depressive episode among clinical trial participants
Recall accuracy for the symptoms of a major depressive episode among clinical trial participants
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DOI：
10.1016/j.jpsychires.2019.03.008
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发表时间：
2019-09-01
影响因子：
4.8
通讯作者：
Craighead, W. Edward
中科院分区：
文献类型：
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作者：
Dunlop, Boadie W.;Granros, Maria;Craighead, W. Edward
对于重度抑郁症 (MDD) 患者，单次发作与反复发作的治疗方法有所不同。然而，根据对社区样本的研究，识别过去事件的准确性较低。先前尚未检查具有明确定义的重度抑郁发作（MDE）的临床样本的回忆准确性。我们在开始治疗后 12 个月和 24 个月时间点的个体和联合治疗抑郁症缓解预测因子 (PReDICT) 研究的随访中评估了 79 名 MDD 患者的事件回忆准确性。使用 DSM-IV 的结构化临床访谈，要求患者回忆在进行摄入评估时是否经历过 MDE 的九个标准症状。 MDE 指数的回忆准确性很高，第 12 个月时 95% 的患者和第 24 个月时 85% 的患者回忆起足够的症状以满足诊断标准。特定症状的回忆准确度差异很大，从烦躁不安和快感缺乏的 90% 以上，到精神运动和体重/食欲变化的 55%。对于死亡/自杀标准的想法，错误回忆的患者更有可能回忆起在摄入评估时出现过的症状（尽管他们当时否认），反之亦然 (p < .007)。参加过临床试验的患者可能会准确地回忆起两年前的 MDE。对于未接受治疗的患者，对自杀意念的最佳警惕应包括自我报告和临床医生评估的结合。
For patients with major depressive disorder (MDD), approaches to treatment differ for those with a single versus recurrent episodes. Based on studies of community samples, however, accuracy is low for identifying past episodes. Recall accuracy among clinical samples with a well-defined major depressive episode (MDE) has not been examined previously. We evaluated episode recall accuracy in 79 MDD patients in follow-up of the Predictors of Remission in Depression to Individual and Combined Treatments (PReDICT) study at 12- and 24-month time-points after starting treatment. Using the Structured Clinical Interview for DSM-IV, patients were asked to recall whether they had been experiencing the nine criterion symptoms of an MDE at the time of their intake assessment. Accuracy of recall for the index MDE was high, with 95% of patients at month 12 and 85% at month 24 recalling sufficient symptoms to meet the diagnostic criteria. Recall accuracy for specific symptoms varied considerably, from > 90% for dysphoria and anhedonia, to 55% for psychomotor and weight/appetite changes. For the thoughts of death/suicide criterion, patients with erroneous recall were significantly more likely to recall having had the symptom at the intake evaluation (though they had denied it at the time) than vice versa (p < .007). Patients who have participated in a clinical trial are likely to recall accurately a past MDE up to two years prior. Optimal vigilance for suicidal ideation for treatment-naive patients should include a combination of self-report and clinician assessments.