A dose-ranging exploratory study of the effects of ethyl-eicosapentaenoate in patients with persistent schizophrenic symptoms.

The objective was to test effects of ethyl eicosapentaenoate (E-E) on persistent ongoing symptoms in patients receiving different types of anti-schizophrenic drugs, typical antipsychotics, new atypical antipsychotics, and clozapine. 115 patients with DSM-IV-defined schizophrenia were studied, 31 on clozapine, 48 on new atypical drugs and 36 on typical antipsychotics. Placebo or 1, 2 or 4 g/day of E-E was given for 12 weeks in addition to the background medication. The main assessment was change from baseline to 12 weeks on the PANSS and its sub-scales. There were no treatment-related side effects or adverse biochemical or haematological effects. Patients on 2 and 4 g/day E-E showed significant reductions in triglyceride levels which had been elevated by clozapine. In patients given 2 g/day E-E there were improvements on the PANSS and its sub-scales, but there was also a large placebo effect in patients on typical and new atypical antipsychotics and no difference between active treatment and placebo. In patients on clozapine, in contrast, there was little placebo response, but a clinically important and statistically significant effect of E-E on all rating scales. This effect was greatest at 2 g/day. There was a positive relationship between improvement on rating scales and rise in red blood cell arachidonic acid concentration.     

度洛西汀与帕罗西汀治疗抑郁症对照分析

目的 探讨度洛西汀和帕罗西汀对抑郁症的疗效及安全性.方法 58例符合CCMD-3诊断标准的抑郁症患者随机分为度洛西汀组28例和帕罗西汀组30例,共治疗6周,用汉密尔顿抑郁量表(HAMD,17项)评定疗效,不良反应量表(TESS)评定治疗中出现的不良反应.结果 两组HAMD评分从治疗1周起明显下降(P<0.05),且一直持续到6周.6周末两组有效率分别为73.3%和78.8%;临床治愈率分别为53.3%和57.6%.两组差异无统计学意义(P>0.05).治疗第l周末度洛西汀组HAMD评分显著低于帕罗西汀组(P<0.05).度洛西汀最常见的不良反应为失眠、头晕、恶心、多汗.结论 度洛西汀治疗抑郁症疗效与帕罗西汀相当,且起效快、不良反应轻微、安全性高.     

艾司西酞普兰联合奎硫平治疗难治性抑郁症患者的对照研究

目的:比较艾司西酞普兰联合奎硫平治疗难治性抑郁症的疗效和安全性方法:74例门诊和住院的难治性抑郁症患者,随机分为研究组38例(艾司西酞普兰联合奎硫平治疗)和对照组36例(单用艾司西酞普兰治疗),治疗8周.采用17项汉密尔顿抑郁量表(HAMD)和汉密尔顿焦虑量表(HA-MA)评价症状严重程度,治疗中出现的症状量表(TESS)评定不良反应. 结果:两组治疗后HAMD和HAMA评分较治疗前均有显著性降低(P均＜0.01);第8周研究组与对照组有效率分别为57.9％、33.3％,两组疗效差异有统计学意义(P＜0.05).研究组和对照组与药物不良反应差异无统计学意义(P＞0.05). 结论:艾司西酞普兰合并奎硫平治疗难治性抑郁症与单用艾司西酞普兰相比,起效较快,疗效较好,同样安全.     

不同药物治疗脑卒中后抑郁症的对比研究

目的探讨不同药物治疗脑卒中后抑郁的临床效果及安全性。方法选取脑卒中后抑郁症患者183例,随机分为A、B 2组。A组95例,给予齐拉西酮治疗,B组88例,给予利培酮治疗。分别于治疗1周、2周、6周末时采用HAMD量表和HAMA量表对2组抑郁及焦虑程度进行评价,计算两项指标减分率,评价2组治疗效果;采用TESS量表对2组不良反应进行评价。结果治疗1周、2周和6周末2组HAMD减分率、HAMA减分率比较差异无统计学意义(P0.05)。2组痊愈率和有效率比较差异无统计学意义(P0.05);治疗1周、2周和6周末2组TESS得分比较差异有统计学意义(P0.05)。结论齐拉西酮与利培酮治疗脑卒中后抑郁患者疗效方面无明显差别,但齐拉西酮的不良反应更小,可作为首选药物应用。     

A systematic review of the treatment of depression with antidepressant drugs in patients who also have a physical illness

To determine whether antidepressants are clinically effective and acceptable for the treatment of depression in people who also have a physical illness. The method used was a systematic review of all randomised controlled trials (found by computer and hand searches) comparing any antidepressant drug with placebo or no treatment, in depressed adults with a specified physical disorder. The main outcome measures are numbers of individuals who recover/improve at the end of the trial and, as a proxy for treatment acceptability, numbers who complete treatment. 18 studies were included, covering 838 patients with a range of physical diseases. 6 studies used SSRIs, 3 atypical antidepressants, and the remainder tricyclics. Patients treated with antidepressants were significantly more likely to improve than those given placebo: about 4 patients would need to be treated with antidepressants to produce one recovery from depression which would not have occurred had they been given placebo (NNT 4.2, 95% CI 3.2-6.4). Most antidepressants (tricyclics and SSRIs together, 15 trials) produced a small but significant increase in dropout (OR 1.66, 95% CI 1.14-2.40. NNH 9.8, 95% CI 5.4-42.9). The "atypical" antidepressant mianserin produced significantly less dropout than placebo. Trends towards tricyclics being more effective than SSRIs, but also more likely to produce dropout were noted. The review provides evidence that antidepressants, significantly more frequently than either placebo or no treatment, cause improvement in depression in patients with a wide range of physical diseases.     

抑郁症患者主观幸福感的对照研究

目的探讨抑郁症患者与正常人在主观幸福感上的差异,以及不同性别的抑郁症患者在主观幸福感上的差异。方法应用总体幸福感量表(GWB)对60名抑郁症患者和60名正常人进行主观幸福感的测定。结果正常被试与抑郁症被试在总体幸福感及各分量表分数上均存在显著的差别(P<0.05)。不同性别的抑郁症患者在正性情绪、负性情绪、总体幸福感的差别具有显著性(P<0.05),女性在幸福感体验和情感体验上都比男性高。结论抑郁症患者的主观幸福感相对正常人较低,女性抑郁症患者在幸福感体验和情感体验上都比男性高。     

A dose-ranging study of the behavioral and cardiovascular effects of CCK-tetrapeptide in panic disorder.

Recent animal studies have shown that pretreatment with centrally active cholecystokinin (CCK) antagonists blocks the anxiogenic effects of CCK-tetrapeptide (CCK-4). In order to determine whether pretreatment with these antagonists can block the anxiogenic effects of CCK-4 in patients with panic disorder, a suitable challenge dose of CCK-4 must be selected. Thus, we conducted a dose range study in which patients with panic disorder (n = 29) were challenged with CCK-4 (10, 15, 20, or 25 micrograms) or placebo on two separate occasions, in a balanced incomplete block design. Patients received in random order 10 micrograms (n = 12), 15 micrograms (n = 11), 20 micrograms (n = 12), or 25 micrograms (n = 12) of CCK-4 or placebo (n = 11). CCK-4 induced anxiety and panic responses in a dose-dependent fashion. The incidence of panic attacks following the CCK-4 challenge was 17% (10 micrograms), 64% (15 micrograms), 75% (20 micrograms), and 75% (25 micrograms). None of the patients panicked with placebo. Moreover, a strong linear relationship between CCK-4 and increases in heart rate and diastolic blood pressure was found. The findings of this study suggest that a dose of 20 micrograms of CCK-4 (ED75) might be suitable for efficacy studies of CCKB antagonists and other potential antipanic drugs in patients with panic disorder.     

难治性抑郁症患者心理社会因素分析

目的探讨心理社会危险因素在难治性抑郁症发病中的相关机制。方法难治性抑郁症患者、非难治性抑郁症患者和正常对照者各30例。被试者完成一般情况问卷、艾森克个性问卷（EPQ）、生活事件量表（LES）、社会支持评定量表（SSRS）,汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）评定。采用t检验、χ2检验、Pearson相关性分析、多元逐步回归分析方法,应用SPSS10.0软件完成数据统计。结果①难治性抑郁症组EPQ内外向因子分显著低于非难治性抑郁症组和正常对照组,神经质因子分显著高于非难治性抑郁症组和正常对照组。负性事件总分、社交及其他问题因子分显著高于非难治性抑郁症组和正常对照组,社会支持总分、客观支持分显著低于非难治性抑郁症组和正常对照组。②HAMD总分与负性事件总分、EPQ精神质因子分、神经质因子分呈正相关,与社会支持总分、主观支持因子分、客观支持因子分、支持利用度因子分呈负相关,HAMA总分与EPQ神经质因子、负性事件总分呈正相关,与EPQ内外向因子分、社会支持总分、支持利用度因子分呈负相关。③多因素分析结果：负性事件和低社会支持是抑郁的危险因素,EPQ神经质因子是焦虑的危险因素。结论性格内向,情绪不稳定,体验较多的负性生活事件,社会支持低下是难治性抑郁症的危险因素。应激、社会支持影响难治性抑郁症的严重程度和预后。     

抑郁症患者防御机制的研究

目的:探讨抑郁症患者防御机制的特点。方法:对60例抑郁症患者以防御方式问卷(DSQ)进行测试,并与60名正常人对照研究。结果:抑郁症患者不成熟和中间型防御机制因子分显著高于正常对照组(P<0.01)。结论:抑郁症患者多使用不成熟及中间型的防御机制,男性患者较女性患者更明显地偏离正常。     

瑞波西汀与多虑平治疗老年抑郁症对照研究

目的观察瑞波西汀治疗老年抑郁症的疗效和安全性。方法随机将60例年龄≥60岁的老年抑郁症患者分为多虑平组（30例）和瑞波西汀组（30例），疗程6周，采用汉密尔顿抑郁量表（HAMD）和副反应量表（TESS）在治疗前和治疗后1、2、4、6周末评定药物疗效和副反应。结果两组疗效无显著差异，HAMD总分反各因子分从疗后2周至6周均较治疗前显著降低，两组间比较无显著性差异；治疗结束时TESS评分瑞波西汀组显著低于多虑平组。结论瑞波西汀适合于老年抑郁症患者的治疗，服用方便、安全，可首选使用。     

氟西汀合并丁螺环酮治疗抑郁症的对照研究

目的　探讨氟西汀合并丁螺环酮治疗抑郁症的有效性及可行性。方法　采用随机对照研究方法 ,入组病例符合CCMD 2 R抑郁症的诊断标准 ,氟西汀合并丁螺环酮 30例为研究组 ,单用氟西汀 30例为对照组 ,用HAMD、HAMA、TESS量表评价疗效及副反应。结果　研究组HAMD减分率自第 2周末开始明显高于对照组 (P <0 .0 5 ) ,HAMA减分率自第 1周末即显著高于对照组 (P <0 .0 1) ,显效率 80 % ,有效率93 3%均高于对照组 ,副反应评分 ,研究组则高于对照组 ,尤其是第 1周明显 ,但无严重副反应 ,不影响治疗。结论　氟西汀合并丁螺环酮治疗抑郁症效果好 ,起效快 ,是可行的治疗方法 ,副作用不影响治疗     

艾司西酞普兰与帕罗西汀治疗抑郁症对照研究

目的:探讨艾司西酞普兰对抑郁症的疗效和安全性. 方法:80例抑郁发作患者随机分为艾司西酞普兰组和帕罗西汀组,每组40例,分别给予艾司西酞普兰和帕罗西汀治疗,疗程6周.以汉密尔顿抑郁量表(HAMD)和汉密尔顿焦虑量表(HAMA)评定疗效;以治疗中出现的症状量表(TESS)评定不良反应. 结果:治疗1～2周,艾司西酞普兰组HAMD、HAMA评分均较帕罗西汀组显著下降(P均<0.05),治疗4～6周,两组相仿(P>0.05).艾司西酞普兰组有效率和治愈率分别为75.7%和54.1%;帕罗西汀组有效率和治愈率分别为80.6%和61.1%;两组差异无显著性(P>0.05).艾司西酞普兰组不良反应总发生率21.6%,较帕罗西汀组44.4%显著为低(P<0.05). 结论:艾司西酞普兰治疗抑郁症疗效与帕罗西汀相似,安全有效,不良反应较轻.     

Outcome at discharge for patients in an ongoing follow-up study of hospital treatment

Methodological and practical difficulties have limited the growth of knowledge about outcome of psychiatric hospital treatment. The authors report on outcome at hospital discharge for 103 long-term and 93 short-term patients treated at the C. F. Menninger Memorial Hospital, part of an ongoing follow-up study of hospital treatment. Discharge outcome is based mainly on ratings of symptoms, global functioning, and therapeutic alliance as well as on patients' reports of satisfaction. At discharge both long- and short-term patients were found to have low levels of symptoms (based on the Brief Psychiatric Rating Scale) and a relatively adequate level of functioning (in the 51-to-60 range on the Global Assessment Scale) and to have been highly satisfied with treatment.     

西酞普兰治疗抑郁症临床观察

目的：评价西酞普兰治疗抑郁症的疗效和不良反应。方法：84例抑郁症患者，随机平分为两组，分别给予西酞普兰和阿米替林治疗，疗程8周。用汉密顿抑郁量表(HAMD)、临床疗效总评量表病情严重程度(CGI—SI)和副反应量表(TESS)评定疗效和不良反应结果：西酞普兰与阿米替林对抑郁症疗效相仿，但前者起效快，不良反应少于后者。结论：西酞普兰是一种安全有效的抗抑郁药。     

路优泰与氟西汀治疗抑郁症对照研究

目的:探讨路优泰对抑郁症患者的疗效及安全性. 方法:将40例抑郁症患者随机分为路优泰组和氟西汀组,治疗6周.采用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)和副反应量表(TESS)评定疗效和不良反应. 结果:路优泰有效率为85%,对抑郁及伴随的焦虑症状作用明显,不良反应少而轻. 结论:路优泰抗抑郁疗效肯定,与氟西汀相当,安全性好.     

西酞普兰与氟西汀治疗抑郁症对照研究

目的：验证西酞普兰治疗抑郁症的疗效及安全性。方法：按前瞻性，随机、单盲法将56例抑郁症患者分为西酞普兰组与氟西汀组。疗程6周。在疗前、治疗1、2、6周用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)评定疗效，用副反应量表(TESS)、实验室检查及体检评价安全性。结果：两组总体疗效相当。但2周末时HAMD评分及减分率、HAMA评分两组问差异有显著性，说明西酞普兰起效较快。两组不良反应均较轻，安全性好。结论：西酞普兰是一种安全有效的抗抑郁药，耐受性及依从性好。     

Using non-steroidal anti-inflammatory drugs in the treatment of depression

BACKGROUND: clinicians have long noticed a correlation between physiological markers of inflammation and depression. The best-known example is the activation of the hypothalamus-pituitary-adrenal axis and cortisol secretion; however more recent studies have demonstrated increased salivary prostaglandins and plasma acute phase proteins in depressed patients. To date four randomised controlled trials have used celecoxib or rofecoxib as adjuncts to serotonin selective reuptake inhibitors in the treatment of depression. These suggested a statistically significant decrease in depressive symptoms in the patients taking NSAIDs and SSRIs, compared to patients taking SSRIs alone. Interpretation of these results is limited by the small sample size and short duration of these preliminary studies. The research only considers depressed patients receiving treatment in secondary care; no study has examined the effectiveness of NSAIDs as an adjunct in primary care, even though most cases of depression in the UK are managed in the community by general practitioners. PROPOSAL: we propose a multi-centre double-blinded randomised controlled trial with two objectives: to determine whether citalopram plus celecoxib dual therapy achieves a greater reduction in depressive symptoms (quantified using the Hamilton Depression Rating Scale (HDRS)) within four weeks, compared to citalopram monotherapy; and to determine whether citalopram plus celecoxib dual therapy is more likely to achieve remission (HDRS score ?7) of moderate to severe depression within six months, compared with citalopram monotherapy. The endpoints will be the reduction in HDRS score after 4 weeks of treatment, and the HDRS score after 26 weeks of treatment. The study will enrol 452 participants from general practices who have a moderate or severe, current or recurrent major depressive episode when medication with an SSRI is considered. The study population will be stratified according to age, sex, HDRS score, age of onset of first episode, number of previous depressive episodes and duration of current episode. The population will then be randomised into two groups. Subjects will be interviewed to determine HDRS score, measure blood pressure, count pills and discuss side-effects. This will occur weekly for the first four weeks, and every four weeks thereafter.