舍曲林联合多学科协作管理模式对青少年首发重度抑郁症患者的疗效研究

The effect of seritaline and multidisciplinary collaborative management model on adolescents with first-episode major depression disorder

目的探究舍曲林联合多学科协作管理模式(MCMM)对青少年首发重度抑郁症(MDD)的临床疗效。方法将2019年1月至2023年11月安徽省阜阳市第三人民医院收治的200例首发MDD青少年,随机分为对照组和MCMM组。两组患者均给予盐酸舍曲林片和精神科常规护理干预8周,MCMM组在此基础上联合多学科协作管理模式干预。比较两组患者干预后临床疗效,两组治疗前后临床量表资料[汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)和心理弹性量表(CD-RISC)]、炎症因子水平[白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)]和神经营养因子指标[5-羟色胺(5-HT)和胶质细胞源性神经营养因子(GDNF)]。结果干预前,两组患者临床量表资料、炎症因子和神经营养因子差异均无统计学意义(P>0.05)。干预8周后,两组患者HAMD评分、HAMA评分、血清IL-1β、IL-6、TNF-α、5-HT和GDNF水平较干预前显著下降(P<0.05),而CD-RISC评分较干预前显著上升(P<0.05)。此外,MCMM组HAMD评分、HAMA评分、IL-1β、IL-6、TNF-α、5-HT和GDNF水平下降程度大于对照组(P<0.05),而CD-RISC评分上升程度大于对照组(P<0.05)。结论与舍曲林联合常规护理相比,MCMM可缓解MDD患者焦虑、抑郁情绪,增强心理韧性,缓解炎症反应。

Objective To explore the clinical efficacy of escitalopram combined with multidisciplinary collaborative management model(MCMM)on adolescents with firstepisode major depressive disorder(MDD).Methods Two hundred adolescents with firstepisode MDD who admitted to Fuyang Third People's Hospital,Anhui Province,from January 2019 to November 2023,were selected as study participnts.They were randomly divided into a control group and a MCMM group.Both groups of patients received sertraline hydrochloride tablets and routine psychiatric care for 8 weeks.Additionally,the MCMM group received an MCMM intervention on this basis.The clinical efficacy of the interventions,pre-and post-treatment assessments included clinical scale data[Hamilton Depression Scale(HAMD),Hamilton Anxiety Scale(HAMA),and Connor-Davidson Resilience Scale(CD-RISC)],inflammatory factors[interleukin-1β(IL-1β),interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α)],neurotrophin factors[serotonin(5-hydroxytryptamine,5-HT)and glial cell-derived neurotrophic factor(GDNF)]were compared between the two groups.Results Before the intervention,there were no statistical differences in the clinical scale data,inflammatory factors and neurotrophic factors between the two groups(P>0.05).After 8 weeks of intervention,the HAMD score,HAMA score,serum IL-1β,IL-6,TNF-α,5-HT,and GDNF levels significantly decreased compared with pre-intervention(P<0.05),while the CD-RISC score significantly increased(P<0.05).In addition,the MCMM group showed greater reductions in HAMD,HAMA,IL-1β,IL-6,TNF-α,5-HT,and GDNF levels and a greater increase in CD-RISC score compared to the control group(P<0.05).Conclusion Compared with sertraline combined with routine care,MCMM significantly alleviates anxiety and depression,enhances psychological resilience,and reduces inflammation in MDD patients.