2008年2月的愛思唯爾期刊《綜合醫(yī)院精神病學》（General Hospital Psychiatry）刊登了美國密歇根大學的一項最新研究,。研究表明，患有抑郁癥的病人通常服用抗抑郁藥物后會在初期有明顯改善,，但是對于有絕望癥狀的患者,，會影響其之后的藥物治療。
研究人員對573名抑郁癥患者進行了抗抑郁藥物的研究,?；颊叻萌N抗抑郁藥物氟西汀，帕羅西汀和舍曲林中的一種,，同時對藥物療效的評定劃分為一個月,、三個月、六個月和九個月。 整體上而言,，抑郁癥患者對藥物有著很快的反應,。68％的患者在最初的第一個月就有明顯改善，有88％的患者在三個月后出現(xiàn)改善情況,。此外,，患者在很多方面都出現(xiàn)了明顯的改變，比如生活以及工作方面,。事實上,，抑郁癥并不僅僅涉及到我們的情緒，而是一個“全身性”的障礙,。它對患者的軀體和心理都具有極大的摧殘性,。對有頭部、背部和腹部疼痛的患者其在服用藥物的第一個月幾乎沒有改善,，正因為如此,，研究人員認為醫(yī)生對此類要考慮采取額外的治療來直接針對有疼痛的抑郁癥患者。
抑郁癥的常見癥狀有心情壓抑,、焦慮,、興趣喪失、精力不足,、悲觀失望,、絕望等。調查結果同時表明,，有些病人可能變成過分悲觀,，出現(xiàn)絕望的癥狀并由此停止繼續(xù)接受本來已經(jīng)有效的治療。研究人員認為這一結果是令人擔憂,，因為絕望是一個非常強會導致自殺的因素,。研究表明，有絕望癥狀的抑郁癥患者盡管他們的情況正在改善,，但有可能導致他們停止繼續(xù)服用藥物，對于具有這類者,，其治療效果更為“循序漸進”,。對于其治療，研究人員認為,，應考慮心理調節(jié)與藥物治療相結合的方法,。(科學網(wǎng) 于乃森 編譯)
生物谷推薦原始出處：
（General Hospital Psychiatry），doi:10.1016/j.genhosppsych.2007.10.003,，James E. Aikens, Ananda Sen
Trajectories of improvement for six depression-related outcomes
James E. Aikens Ph.D., Kurt Kroenke M.D. Donald E. Nease Jr. M.D. Michael S. Klinkman M.D., M.S. and Ananda Sen Ph.D.
Abstract
Objective
Although depression treatment improves diverse outcomes, it is unclear whether these improvements are comparable in magnitude and timing. The objective was therefore to compare treatment-related improvements in depressive symptoms, work and social functioning, hopefulness, somatic complaints and positive well-being.
Method
Secondary analysis of a large clinical trial of selective serotonin reuptake inhibitors for primary care depression. Depressed patients (n=573) from 37 practices from two primary care networks were randomized to fluoxetine, paroxetine or sertraline, and then followed naturalistically. At 1, 3, 6 and 9 months after treatment initiation, assessments were made of depressive symptom severity, social and work functioning, positive well-being, hopefulness beliefs and somatic complaints. Data were analyzed with linear regression modeling.
Results
Although 68% and 88% of total mood improvement occurred by Months 1 and 3, respectively, improvement plateaued sooner for somatic complaints (P=.001 at Month 1), and more gradually for hopefulness [P (Month 1)=.015, P (Month 3)=.036]. Although magnitude of improvement was interrelated across outcomes, timing of mood improvement was unrelated to the timing of improvement in both somatic complaints and hopefulness. Improvement in somatic complaints was primarily attributable to improvements in head, back and stomach pain.
Conclusions
Work and social functioning, and positive affect improve synchronously with mood. Compared to mood, improvement in pain complaints peaks earlier, whereas improvement in hopefulness is much more linear over time. Because depression treatment response appears to be complex and multidimensional, a broader conceptualization of depression remission may be indicated.
