抑郁症患者焦虑/躯体化症状早期的变化与氟西汀疗效的相关性研究

目的探讨抑郁症患者焦虑／躯体化症状的早期变化对氟西汀抗抑郁治疗达症状缓解的预测作用。方法对103例重症抑郁患者给予氟西汀治疗6w,剂量固定于20 mg／d,于治疗前及治疗后的第1、2、4、6w末用汉密顿抑郁量表17项(HAMD-17)评定临床症状,其中焦虑／躯体化因子分用来评定焦虑／躯体化症状。结果治疗6w末103例患者中32例(31．1％)达到症状缓解标准,71例(68．9 ％)未达到症状缓解标准。早期HAMD-17中焦虑／躯体化因子分及胃肠道症状条目分的变化与症状缓解存在正相关,而该因子中其余条目的变化与症状缓解不相关。结论HAMD-17中焦虑／躯体化因子分及胃肠道症状有关的条目分早期改善可能是氟西汀治疗后症状能基本缓解的预测因子。

The correlation between early changes of anxiety/somatization symptoms and treatment outcome under fluoxetine in major depressive disorder patients

Objective:To examine the predictive function about early changes of anxiety/somatization symptoms to remission with fluoxetine treatment among major depressive disorder (MDD) patients who participated in the study . Methods:103 MDD patients were treated with fluoxetine (20mg/d) for 6 weeks. Before and after treatment for 1,2,4,6 weeked, clinical symptoms of fluoxetine was assessed with HAMD - 17. The anxiety/somatization factor of the HAMD - 17 was used to assess anxiety/somatization symptoms. Results: 32 patients (31.1% )among103 who remitted and 71 patients(68.9%)who did not remitted after treated for 6 weeks. Remitters had significantly greater early improvement in anxiety/somatization factor scores and somatic symptoms (gastrointestinal) scores than non-remitters. No other significant differences in early changes were noted for the remaining items between remitters versus non-remitters who received fluoxetine treatment. Conclusion:The presence of early improvement on the HAMD - 17 fator of anxiety/somatization symptoms and itom concerning gastrointestinal symptoms may be possible predictors of achieving remission at endpoint with fluoxetine treatment.