Predicting relapse from the time to remission during the acute treatment of depression: A re-analysis of the STAR*D data
Predicting relapse from the time to remission during the acute treatment of depression: A re-analysis of the STAR*D data
复制标题
预测抑郁症急性治疗期间从缓解到缓解的复发：STAR*D 数据的重新分析
DOI：
10.1016/j.jad.2022.09.162
复制
发表时间：
2023
影响因子：
6.6
通讯作者：
Uchida Hiroyuki
中科院分区：
文献类型：
--
作者：
Kubo Kaoruhiko;Sakurai Hitoshi;Tani Hideaki;Watanabe Koichiro;Mimura Masaru;Uchida Hiroyuki
背景在抑郁症的维持治疗期间预测复发是具有挑战性的。这项分析的目的是调查急性期达到缓解的时间和随后的复发率或复发时间之间的关系，使用排序的治疗替代方案来缓解抑郁。方法分析1296名门诊的非精神病性抑郁症患者的数据，这些患者在西酞普兰缓解长达14周后进入12个月的自然随访期。对2、4、6、9、12、14周达到缓解者的复发率和复发天数进行单因素方差分析和乔克希尔-特普斯特拉趋势检验。缓解和复发分别以≤5和≥11在16个项目的抑郁症状和自我报告量表上的得分来定义。结果每周达到缓解者的复发率有显著差异(F(5,1087)=4.995，P<0.001)。4周达到缓解者复发率最低(25.7%)，12周达到缓解者复发率最高(42.4%)，差异有统计学意义(P=0.006)。在达到缓解的几周和复发的天数之间也有显著的负面趋势(z=−6.13，p<；0.001)。结论抗抑郁药物治疗反应较快的抑郁症患者更有可能长期保持缓解。这一发现表明，为了防止复发，应该密切关注需要相对较长时间才能缓解的患者。
BackgroundPredicting relapse during maintenance treatment for depression is challenging. The objective of this analysis was to investigate the association between the time taken to achieve remission in the acute phase, and the subsequent relapse rate or time to relapse using the Sequenced Treatment Alternatives to Relieve Depression dataset.MethodData of 1296 outpatients with nonpsychotic depression who entered a 12-month naturalistic follow-up period after achieving remission with citalopram for up to 14 weeks were analyzed. One-way analysis of variance and the Jonckheere-Terpstra trend test were performed to compare the relapse rates and days to relapse during the follow-up period among those who achieved remission at weeks 2, 4, 6, 9, 12, and 14. Remission and relapse were defined as scores of ≤5 and ≥11, respectively, on the 16-Item Quick Inventory of Depressive Symptomatology and Self-Report.ResultsThe relapse rates were significantly different among those who achieved remission each week (F(5, 1087)= 4.995, p < 0.001). The lowest and highest relapse rates were observed in those who achieved remission at weeks 4 (25.7 %) and 12 (42.4 %), respectively, with a significant difference (p = 0.006). There was also a significant negative trend between the weeks taken to achieve remission and the days to relapse (z = −6.13, p < 0.001).ConclusionsPatients with depression who show a faster response to antidepressant treatment are more likely to maintain remission in the long term. This finding suggests that, to prevent relapse, close attention should be paid to patients who require a relatively long time to achieve remission.