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PROSPECTIVE STUDY ON THE TREATMENT AND PREDICTING EFFICACY IN REFRACTORY DEPRESSION

难治性抑郁症治疗及预测疗效的前瞻性研究

基本信息

批准号：
14570934
负责人：
NAGAYAMA Haruo
金额：
$ 2.24万
依托单位：
OITA UNIVERSITY (FACULTY OF MEDICINE)
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2002
资助国家：
日本
起止时间：
2002 至 2003
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-14570934/
关键词：
DEPRESSION SPECT ECT PREDICION OF EFFECT PERSONALITY DISORDER GAF DEX CRH TEST MRI 付加療法治療反応予測因子バイオロジカルマーカー

项目摘要

(1)The patients with major depressive disorder received the Thyrotropin-releasing hormone (TRH) test and the combined dexamethasone/corticotropin-releasing hormone (DEX/CRH) test on the 4th through the 7th hospital days and at the time of improvement. Results : None of the indices in these. tests at the time of admission correlated with the Hamilton Rating Scale for Depression (HRSD) or the Global Assessment for Function (GAF). However, since the ΔMAXACTH, ACTHAUC, ΔMAXcortisol, and CortisolAUC showed significant decreases at the time of improvement compared with the time of admission. ΔMAXTSH showed no significant change. Prediction of improvement within 3 months after admission was not possible with either test alone. However, the quotient which divided ΔMAXACTH by ΔMAXTSH was predictive of clinical improvement.(2)Patients with major depressive disorder were evaluated using single photon emission computed tomography (SPECT), HRSD, and GAF scale. Nineteen of these patients also underwent the same tests during remission. Results : Global cerebral blood flow (gCBF) was significantly higher during remission than at the time of enrollment. Significant correlations were seen between gCBF and age, duration of previous episode of depression, lifetime alcohol consumption, psychomotor retardation, and hypochondriasis. However, no correlation was seen between gCBF and HRSD, GAF, severity and duration of depressive episode, or melancholia-type depression.(3)Subjects with major depressive disorder who were resistant to antidepressant therapy or who, due to adverse reactions, could not undergo pharmacotherapy at adequate doses for sufficient durations. Results : Significant positive correlations were seen between final improvement rate with ECT and improvement rate at completion of 3 ECT sessions, and significant negative correlations were seen between final improvement rate and adequacy of pharmacotherapy before ECT.

（1）抑郁症患者在入院后第4 ~ 7天及病情好转时进行促甲状腺激素释放激素（TRH）和地塞米松/促肾上腺皮质激素释放激素（DEX/CRH）联合检测。结果：上述指标均无变化。入院时的测试与汉密尔顿抑郁评定量表（HRSD）或整体功能评估（GAF）相关。然而，由于与入院时相比，改善时的ΔMAXACTH、ACTH AUC、Δ MAX皮质醇和皮质醇AUC均显著降低。ΔMAXTSH无显著变化。单独使用任何一项测试都无法预测入院后3个月内的改善。然而，ΔMAXACTH除以ΔMAXTSH的商可预测临床改善。（2）采用单光子发射计算机断层扫描（SPECT）、HRSD和GAF量表对抑郁症患者进行评估。其中19名患者在缓解期也接受了相同的检查。结果：缓解期的总体脑血流量（gCBF）显著高于入组时。gCBF与年龄、既往抑郁发作持续时间、终生饮酒、精神发育迟滞和低血糖之间存在显著相关性。然而，gCBF与HRSD，GAF，抑郁发作的严重程度和持续时间，或抑郁症型抑郁症之间没有相关性。（3）对抗抑郁药治疗有抵抗力或由于不良反应而不能接受足够剂量和足够时间的药物治疗的重度抑郁症受试者。结果如下：ECT的最终改善率与完成3次ECT治疗时的改善率之间存在显著正相关，最终改善率与ECT前药物治疗的充分性之间存在显著负相关。