Clinical characteristics of response to fluoxetine treatment of obsessive-compulsive disorder.
Clinical characteristics of response to fluoxetine treatment of obsessive-compulsive disorder.
复制标题
氟西汀治疗强迫症反应的临床特征。
DOI：
10.1097/00004714-199806000-00002
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发表时间：
1998
影响因子：
2.9
通讯作者：
Bystritsky,A
中科院分区：
文献类型：
--
作者：
Ackerman,DL;Greenland,S;Bystritsky,A
氟西汀是治疗强迫症的有效药物。尽管如此，仍有相当数量的患者没有反应或仅有部分改善。对氟西汀多中心、安慰剂对照、固定剂量试验产生的数据进行重新分析，以确定应答者的特征。采用多元回归方法评价治疗反应与基线指标之间的关系，如症状严重程度、症状类型（强迫、强迫、抑郁）、病程、既往治疗、发病年龄和其他人口统计学因素（年龄、种族和性别）。氟西汀在所有结局指标上均比安慰剂有效。与20毫克剂量相比，60毫克剂量与耶鲁-布朗强迫症量表总分的更大下降和强迫性项目的更大下降相关。缓解史、既往未接受过药物治疗或仅接受过行为治疗、强迫症较严重（尤其是强迫症带来的干扰和痛苦较大）或汉密尔顿抑郁量表评分较低或较高的患者的缓解率和总体改善最大。这项研究没有发现反应与当前年龄，强迫症发病年龄，性别和种族之间的任何联系。在安慰剂组中，未发现评价的人口统计学或临床因素与改善相关。（J Clin Psychopharmacol 1998; 18：185-192）
Fluoxetine is effective in treating obsessive-compulsive disorder (OCD). Nonetheless, a substantial number of patients do not respond or have only partial improvement. Data generated by a multicenter, placebo-controlled, fixed-dose trial of fluoxetine were reanalyzed to identify characteristics of responders. Multiple regression methods were used to evaluate the relationship between therapeutic response and baseline measures such as severity of symptoms, type of symptoms (obsessions, compulsions, depression), course of illness, previous treatment, age of onset, and other demographic factors (age, race, and sex). Fluoxetine was more effective than placebo on all outcome measures. A 60-mg dosage was associated with a greater drop in Yale-Brown Obsessive-Compulsive Scale total score and a greater drop in Compulsion items than a 20-mg dosage. Response rates and overall improvement were greatest for patients with a history of remissions, with no previous drug treatment or with only prior behavior therapy, with more severe OCD (especially with greater interference and distress from obsessions), or with either low or high Hamilton Rating Scale for Depression scores. This study did not detect any associations between response and current age, age of OCD onset, gender, and race. None of the demographic or clinical factors evaluated was found to be related to improvement in the placebo group.(J Clin Psychopharmacol 1998; 18: 185-192)