沉思对首发抑郁症患者抗抑郁药物治疗效果的影响

Baseline rumination impacts the prognosis of patients with first-episode depression

目的探讨沉思及其亚型冥思与反思对首发抑郁症患者接受抗抑郁药物治疗效果的影响。方法纳入75例首发抑郁症患者,接受抗抑郁药物治疗8周,治疗前后均采用17项汉密尔顿抑郁量表(Hamilton depression scale,HAMD)、沉思反应量表对抑郁症状和沉思进行评估,根据治疗后抑郁症状程度分为治愈组与未治愈组,比较两组在治疗前后的沉思差异以及基线期沉思对治疗效果的影响。结果经重复测量方差分析显示,患者HAMD、沉思以及冥思的分组主效应和时间主效应均有统计学意义(P<0.05),其中治愈组在治疗前后沉思及冥思评分均低于未治愈组,差异有统计学意义(P<0.05);未治愈组与治愈组HAMD、沉思、冥思与反思评分在治疗后均较治疗前降低(P<0.05)。阶层logistic回归分析示,治疗前沉思得分对治疗效果有预测作用(OR=1.008,95%CI:1.017~1.131);冥思得分对治疗效果有预测作用(OR=1.208,95%CI:1.065~1.371)。结论基线期沉思及冥思对首发抑郁症患者接受抗抑郁药物治疗后的疗效有一定程度的预测作用。

Objective To investigate whether baseline rumination and its subtypes predict the non-remitted depression in patients with first-episode depression.Methods Seventy-five patients with first-episode depression were recruited.All subjects were divided into remitted group and non-remitted group according to the severity of their depression after 8 weeks follow up.The measures included the 17-item Hamilton depression Rating Scale(HAMD)and Ruminative Response Scale(RRS).Hierarchical logistic regression models were conducted by using SPSS 19.0.Results Repeated measure ANOVA for the scores of HAMD,RRS and brooding showed that the main effect of time and the main effect of group were significant(P<0.05).The RRS and brooding scores were lower in remitted group than in non-remitted group before and after treatment(P<0.05).HAMD,RRS,brooding and reflection scores in two groups were significantly decreased after treatment(P<0.05).Baseline RRS predicted the non-remitted depression in patients with first-episode depression(OR=1.008,95%CI:1.017~1.131)at 8 weeks follow-up.Baseline brooding predicted the non-remitted depression in patients with first-episode depression at 8 weeks follow-up(OR=1.208,95%CI:1.065~1.371).Conclusion Rumination and its brooding can predict the non-remitted depression in patients with first-episode depression.