Possibility of pharmacogenetic approach suicide prevention in pediatoric major depressive disorder treatment.

对127例患者进行筛查，根据Zung抑郁自评量表（SDS）40分或以上和精神疾病诊断与统计手册第四版修订本（DSM-IV-TR）筛选出43例有抑郁倾向的患者（男16例，女27例;平均年龄14.3岁;标准差[SD] 1.3岁）。抑郁症的诊断由两名评估者（包括持牌儿科心理医生）使用结构化临床访谈确定。100名健康受试者（23-68岁）在研究中用作对照。两组均进行5-HTTLPR和BDNF基因分型。对照组5-HTTLPR变异频率为：S等位基因（sl和ss基因型）为98%，BDNF Val 66 Met为67%。5-HTTLPR变异的频率如下：患者组中S等位基因（sl和ss基因型）为94%，BDNF Val 66 Met为70%。5-HTTLPR（χ 2检验，p =0.20）和BDNF（χ 2检验，p =0.76）变异的频率在对照组和患者组之间无显著性差异。患者随机分为帕罗西汀20 mg/d组和氟脲沙明25 mg/d组，疗程6周。采用Zung抑郁自评量表（SDS）对所有患者进行初始和第6周的评定。治疗6周后SDS评分下降至少10%的患者定义为应答者。5-HTTLPR基因型的频率在应答组和非应答组之间没有显著差异（χ ^2检验，p=0.33）。BDNF基因型的频率在应答者和无应答者之间没有显著差异（χ ^2检验，p =0.8）。由于样本量较小，需要进一步收集样本。此外，考虑到5-HTTLPE是多等位基因的，使用的SSRI分为帕罗西汀和氟鲁伏沙明，本研究未考虑性别，需要进一步分析。

Screenings were conducted on 127 patients, and 43 patients (16boys and 27 girls ; mean age, 14.3 years ; standard deviation [SD], 1.3years) who have shown predisposition for depression were selected based on a Zung self-rating depression scale (SDS) of 40 points or above and Diagnostic and Statistical Manual of Mental Disorders Fourth Edition, Text Revision (DSM-IV-TR). The diagnosis of Depressive disorder was established by two raters including Licensed pediatric-psychological clinician using the Structured Clinical Interview. One hundred healthy subjects (23-68 years) were used as control in the study. Both groups were genotyped for 5-HTTLPR and BDNF. The frequency of the 5-HTTLPR variant was described as below : S allele (sl and ss genotype) was 98% , and for BDNF Val66Met was 67% in the control group. The frequency of the 5-HTTLPR variant was described as below : S allele (sl and ss genotype) was 94% , and for BDNF Val66Met was 70% in the patient group. No significant difference for the frequency of the 5-HTTLPR(χ^2test,p=0.20) and BDNF variants (χ^2test,p=0.76)was found between the control group and the patient group. The patients were randomly assigned to either paroxetine20mg/day or fuluvoxamin25mg/day for 6weeks. All patients were evaluated initially and at weeks 6 using Zung self-rating depression scale (SDS). Patients who showed a minimum of 10% decrease in the SDS score after 6 weeks of treatment were defined as a responder. The frequencies of the 5-HTTLPR genotypes did not significantly differ between the responder and in the non-responder group(χ^2test, p=0.33). The frequencies of the BDNF genotypes did not significantly differ between the responders and in the non-responders(χ^2test,p=0.8). Since the sample size is small, further sample collection is needed. Moreover, considering 5-HTTLPE is multi-allelic, the SSRI used are divided into paroxetine and fuluvoxamin, and gender is not considered in this study, further analysis is needed.