任小丹,田琪,周佳,任艳萍,肖乐.抑郁障碍急性期单药治疗和联合治疗对患者生活质量的影响[J].四川精神卫生杂志,2023,(5):388-395.Ren Xiaodan,Tian Qi,Zhou Jia,Ren Yanping,Xiao Le,Effects of acute-phase monotherapy and combination therapy on quality of life in patients with depressive disorders[J].SICHUAN MENTAL HEALTH,2023,(5):388-395
抑郁障碍急性期单药治疗和联合治疗对患者生活质量的影响
Effects of acute-phase monotherapy and combination therapy on quality of life in patients with depressive disorders
投稿时间:2023-03-08  
DOI:10.11886/scjsws20230308002
中文关键词:  抑郁障碍  急性期  生活质量  单药治疗  联合治疗
英文关键词:Depression  Acute phase  Quality of life  Monotherapy  Combination therapy
基金项目:国家重点研发计划“重大慢性非传染性疾病防控研究”重点专项(项目名称:精神心理疾病临床队列共享平台建设,项目编号:2017YFC1311101)
作者单位邮编
任小丹 首都医科大学附属北京安定医院国家精神心理疾病临床医学研究中心北京 100088 100088
田琪 北京市丰台区心理卫生中心北京 100076 100076
周佳 首都医科大学附属北京安定医院国家精神心理疾病临床医学研究中心北京 100088 100088
任艳萍 首都医科大学附属北京安定医院国家精神心理疾病临床医学研究中心北京 100088 100088
肖乐* 首都医科大学附属北京安定医院国家精神心理疾病临床医学研究中心北京 100088 100088
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中文摘要:
      背景 目前,抑郁障碍患者的临床治疗缺乏有针对性的治疗结局评估。生活质量作为一种以患者价值为导向的次要结局,具有较高的评估价值,国内缺少关于评估抑郁障碍急性期不同治疗方案对患者生活质量影响的大样本前瞻性队列研究。目的 探讨抑郁障碍患者急性期单药治疗和联合治疗对其生活质量的影响,以期为抑郁障碍患者优化治疗结局提供参考。方法 采用前瞻性随访队列研究,于2020年8月24日-2021年11月29日,在中国18个城市的22家医院中,纳入符合《精神障碍诊断与统计手册(第5版)》(DSM-5)抑郁发作或复发性抑郁障碍的患者1 330例。根据抑郁障碍急性期治疗方案,将患者分为单药治疗组(n=969)和联合治疗组(n=361)。分别于基线期、治疗半月末以及治疗1、2、3、6、9、12个月末,采用抑郁症状量表(IDS-SR30)、简明幸福与生活质量满意度问卷(Q-LES-Q-SF)、简明健康风险跟踪量表(CHRT)以及席汉残疾量表(SDS)进行评定,于治疗后各访视时间点进行频率、强度及负担自评量表(FIBSER)评定。采用Spearman相关分析考查两组患者生活质量与自杀风险、不良反应以及社会功能损害的相关性。结果 治疗3个月末,单药治疗组Q-LES-Q-SF评分高于联合治疗组,差异有统计学意义(Z=2.008,P<0.05)。两种治疗方案时间效应有统计学意义(F=111.393,P<0.01)。治疗3个月末,单药治疗组和联合治疗组Q-LES-Q-SF评分与CHRT和SDS评分均呈负相关(r=-0.660、-0.712、-0.634、-0.718,P均<0.01)。结论 单药治疗和联合治疗均有助于改善急性期抑郁障碍患者的生活质量,但单药治疗对患者生活质量的改善可能优于联合治疗。
英文摘要:
      Background The treatment of patients with depressive disorders is short of targeted outcome assessment. As a secondary outcome that is guided by patient values, quality of life is thus of relatively high evaluative value. In China, there exists a lack of large sample prospective cohort studies evaluating the effect of different treatment protocols on quality of life in patients with acute depressive disorder.Objective To explore the effects of monotherapy and combination therapy on the quality of life of patients with depressive disorder in acute phase, so as to provide references for optimizing the outcome of treatment for such patients.Methods A prospective follow-up cohort study from August 24, 2020 to November 29, 2021 was conducted, including 1 330 patients from 22 hospitals across 18 cities in China. All these patients met the diagnostic criteria for depressive episodes, recurrent depressive disorder from the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). Patients were divided into monotherapy group (n=969) and combination therapy group (n=361) according to the acute phase treatment protocol. At baseline, the end of the first half month as well as the 1st, 2nd, 3rd, 6th, 9th and 12th months of treatment, patients were assessed with Inventory of Depressive Symptomatology Self-report (IDS-SR30), Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF), Concise Health Risk Tracking Scale (CHRT) and Siehan Disability Scale (SDS). Frequency, Intensity, and Burden of Side Effects Rating (FIBSER) was adopted for assessment at each visit time point of treatment. Spearman correlation analysis was adopted to examine the correlation of quality of life with suicide risk, adverse reactions and impaired social functioning among patients.Results At the end of three months of treatment, the Q-LES-Q-SF score of monotherapy group was higher than that of combination therapy group, and the difference was statistically significant (Z=2.008, P<0.05). The time effects of both treatment protocols possessed statistical significance (F=111.393, P<0.01). At the end of three months of treatment, the Q-LES-Q-SF score was negatively correlated with CHRT and SDS scores, respectively, in both monotherapy group and combination treatment group (r=-0.660, -0.712, -0.634, -0.718, P<0.01).Conclusion Both monotherapy and combination therapy can facilitate the improvement of the life quality of patients with acute depressive disorder, but monotherapy may achieve better than the combination therapy in this aspect. [Funded by The National Key Research and Development Program of China "Research on the Prevention and Control of Major Chronic Non-communicable Diseases" (number, 2017YFC1311101)]
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