Serious life events among resistant and non-resistant MDD patients
Serious life events among resistant and non-resistant MDD patients
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DOI：
10.1016/j.jad.2008.01.006
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发表时间：
2008-10-01
影响因子：
6.6
通讯作者：
Spivak, B.
中科院分区：
文献类型：
--
作者：
Amital, D.;Fostick, L.;Spivak, B.
背景：超过60%的重度抑郁障碍(MDD)患者对治疗没有完全反应。其中一半人最终将完全没有反应，将被称为难治性抑郁症(TRD)患者。应激性生活事件被发现与MDD有关，也被发现影响疾病的进程。我们假设负性生活事件可能是TRD的独立危险因素)。方法：107名单相MDD患者，全部治疗至少4周，纳入研究。结果：39.3%的受试者被定义为TRD患者，60.7%的受试者为非TRD患者。TRD患者有更严重的抑郁，更多的自杀未遂，更多的住院，更长的发作，以及接受更多的苯二氮类药物，抗精神病药物和ECT。失业和经济压力在TRD群体中更为普遍。总体而言，TRID患者比应答者有更多的负性生活事件。限制：这是一项回溯性研究。此外，TRD的定义是一分为二的，因此没有检验应激性生活事件的数量与抵抗程度之间的关系。结论：失业和经济困难可以预测TRD。失去父母和严重的健康状况与TRD无关，这表明影响MDD发展的事件并不一定影响治疗结果。(C)2008爱思唯尔B.V.保留所有权利。
Background: Over 60% of patients with major depressive disorder (MDD) do not respond fully to therapy. Half of them eventually will not respond at all and will be referred to as treatment resistant depression (TRD) patients. Stressful life events were found to be associated with MDD and were also found to affect the course of the disease. We hypothesize that negative life events might be an independent risk factor for TRD).Methods: One hundred and seven unipolar MDD patients, all treated for at least 4 weeks, were enrolled in the study. Patients were assessed on their psychiatric and medical history, and seven categories of stressful life events.Results: 39.3% of participants were defined as TRD patients and 60.7% as non-TRD. TRD patients had more severe depression, more past suicide attempts, more hospitalizations, longer episodes, and received more benzodiazepines, anti psychotics, and ECT. Job loss and financial stress were more prevalent among the TRD group. Overall, the TRID patients had more negative life events than responders.Limitations: This is a retrospective study. In addition, the definition of TRD was done dichotomically, therefore the association between number of stressful life events and the degree of resistance was not tested.Conclusions: Job loss and financial distress were found to predict TRD. The loss of a parent and severe health conditions were not associated with TRD, suggesting that events affecting the development of MDD, do not necessarily affect the treatment outcome. (C) 2008 Elsevier B.V. All rights reserved.