治疗不敏感性抑郁症的临床特征与治疗转归

目的探讨治疗不敏感性抑郁症的临床特征与治疗转归。方法采用前瞻性的研究方法对入组的147例抑郁症患者进行随访,共124例患者完成整个研究。在治疗前、治疗1、2、4、6周末进行症状评估,评估工具包括汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、简明精神病量表(BPRS)、临床疗效总评量表、副反应量表。结果(1)A、B、C、D4组治疗有效率分别为86.21%、86.96%、50.00%和58.33%,但A组的脱落率较高,达18.69%;(2)治疗敏感性抑郁症患者的症状指标在随访3(7±1)d即有下降;而治疗不敏感性抑郁症患者在随访4(14±1)d才下降,治疗前精神性焦虑症状相对较轻,均分约少1.2分,治疗后遗留较多症状,具体为HAMD的焦虑/躯体化、阻滞、HAMA的精神性焦虑、躯体性焦虑、BPRS的焦虑忧郁、缺乏活力、激活性。结论不敏感性抑郁症患者治疗前精神性焦虑症状较轻,症状改善较慢,治疗后遗留较多抑郁焦虑的症状。

Clinical characters and treatment outcome in non-responsive depression

Objective To explore the clinical characters and treatment outcome in non-responsive depression by using the prospective study method.Methods 147 major depression patients were followed up,and about 124 patients completed the whole investigation.The severity of the symptoms was assessed at baseline and 1,2,4,6 weekends after the treatment.The assessments included Hamilton Depression Scale(HAMD),Hamilton Anxiety Scale(HAMA),the Brief Psychiatric Rating Scale(BPRS),Clinical Global Impression(CGI),and Treatment Emergent Symptom Scale(TESS).Results(1)The curative effects were about 86.21%,86.96%,50% and 58.33% in group A,B,C and D,respectively.But the ratio of quitting the investigation in group A was high,about 18.69%.(2)The symptoms of the responsive depression patients improved at about one week after the treatment,and two weeks in the non-responsive depression.The psychogenic anxiety in the non-responsive depression was about 1.2 point,which was less than that in the responsive depression at baseline.More symptoms,such as anxiety,somatization,blockage in HAMD,psychogenic and somatic anxiety in HAMA,anxiety-melancholy,vigorless,and activation in BPRS,were remained after the treatment in non-responsive depression.Conclusions The psychogenic anxiety in the non-responsive depression is slight at baseline.The symptoms improve late,and more depression and anxiety symptoms are remained after the treatment in non-responsive depression.