Hamilton depression rating subscales to predict antidepressant treatment outcome in the early course of treatment
Hamilton depression rating subscales to predict antidepressant treatment outcome in the early course of treatment
复制标题
DOI：
10.1016/j.jad.2014.12.043
复制
发表时间：
2015-04-01
影响因子：
6.6
通讯作者：
Tadic, Andre
中科院分区：
文献类型：
--
作者：
Helmreich, Isabella;Wagner, Stefanie;Tadic, Andre
背景资料：汉密尔顿抑郁评定量表（HAMD）分量表为全量表提供了一种经济的替代方案;然而，尚未研究其在治疗早期（El）检测改善发作的能力。本研究调查了重性抑郁症（MD）患者在早期治疗过程中，分量表是否是预测治疗缓解的一个可比选择。基于一项为期6周的随机、安慰剂对照试验的210名MD患者的数据，该试验比较了米氮平（MIR）和帕罗西汀（PAR），在总的和治疗亚组（MIR vs. PAR）中，用7个分量表和HAMD（17）评价EI对治疗结束时（稳定）缓解的区分和预测有效性。结果：只有Evans（6）和多伦多（7）分量表与HAMD（17）分量表具有几乎相同的预测值（例如，敏感性稳定缓解Evans（6）/多伦多（7）：96/95% vs. 96%HAMD（17））。对于大多数子量表，El预测缓解的最佳截止值略低于20%，对于稳定缓解略高于20%。局限性：研究样本的代表性，非独立的分量表，缺少外部验证标准，缺乏控制group.Conclusions：埃文斯和多伦多7分量表是有价值的替代品的情况下，经济方面发挥了更大的作用。总评分降低>= 20%作为EI的定义似乎也适用于HAMD分量表，在总体和抗抑郁药亚组中。(C)2015 Elsevier B. V.版权所有。
Background: Hamilton depression rating scale (HAMD) subscales provide an economic alternative for the full scale; however, their ability to detect onset of improvement in the early course of treatment (El) has not yet been researched. The present study investigated in patients with major depression (MD) whether the subscales are a comparable option to predict treatment remission in the early course of treatment.Methods: Based on data from 210 MD patients of a 6-week randomised, placebo-controlled trial comparing mirtazapine (MIR) and paroxetine (PAR), the discriminative and predictive validity of El for (stable) remission at treatment end was evaluated for seven subscales and the HAMD(17) in the total and in treatment subgroups (MIR vs. PAR). Receiver operating characteristics (ROC) curves (at week 2) and the Clinical Global Impression scales (CGI) (at study endpoint) were used to validate the 20% EI criterion for the subscales.Results: Only the Evans(6) and Toronto(7) subscale had almost the same predictive value as the HAMD(17) (e.g., sensitivities stable remission Evans(6)/Toronto(7): 96/95% vs. 96% HAMD(17)). The optimal cut-off for El to predict remission was just below 20% for most subscales and slightly over 20% for stable remission. Limitations: Study sample representativeness, non-independence of subscales, missing external validation criterion, lack of control group.Conclusions: The Evans and Toronto7 subscales are valuable alternatives in situations, where economic aspects play a larger role. A sum score reduction of >= 20% as definition for EI seems also appropriate for the HAMD subscales, in the total as well as in the antidepressant subgroups. (C) 2015 Elsevier B.V. All rights reserved.