Prediction of 12-Week Remission by Psychopharmacological Treatment Step in Patients With Depressive Disorders
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objective To investigate the predictors of remission by 4 treatment steps in depressive outpatients receiving 12-week psychopharmacotherapy.Methods Patients were consecutively recruited at a university hospital in South Korea from March 2012 to April 2017. At baseline, 1,262 patients were evaluated for sociodemographic and clinical data including assessments scales, and were received antidepressant monotherapy. For patients with an insufficient response or uncomfortable side effects, next treatment steps (1, 2, 3, and 4) with alternative strategies (switching, augmentation, combination, and mixtures of these approaches) were administered considering measurements and patient preference at every 3 weeks in the acute treatment phase (3, 6, 9, and 12 weeks). Remission was defined as a Hamilton Depression Rating Scale score of ≤7.Results In the multi-variate logistic regression analyses, remission was predicted by higher functional levels in patients received Step 1 and 2 treatment; by lower life stressors in Step 1; by higher social support in Step 3 and 4; and by lower suicidality in Step 1–3.Conclusion Differential associations were found between symptoms or functions and treatment steps, which suggested that multi-faceted evaluations at baseline could predict remission by treatment steps.
Abstract
Objective To investigate the predictors of remission by 4 treatment steps in depressive outpatients receiving 12-week psychopharmacotherapy.Methods Patients were consecutively recruited at a university hospital in South Korea from March 2012 to April 2017. At baseline, 1,262 patients were evaluated for sociodemographic and clinical data including assessments scales, and were received antidepressant monotherapy. For patients with an insufficient response or uncomfortable side effects, next treatment steps (1, 2, 3, and 4) with alternative strategies (switching, augmentation, combination, and mixtures of these approaches) were administered considering measurements and patient preference at every 3 weeks in the acute treatment phase (3, 6, 9, and 12 weeks). Remission was defined as a Hamilton Depression Rating Scale score of ≤7.Results In the multi-variate logistic regression analyses, remission was predicted by higher functional levels in patients received Step 1 and 2 treatment; by lower life stressors in Step 1; by higher social support in Step 3 and 4; and by lower suicidality in Step 1–3.Conclusion Differential associations were found between symptoms or functions and treatment steps, which suggested that multi-faceted evaluations at baseline could predict remission by treatment steps.
참고문헌 (25)
- Trivedi MH, "Evaluation of outcomes with citalopram for depression using measurement-based care in STAR*D: implications for clinical practice", Am J Psychiatry, 163, pp.28~40 (2006)
- Kim JM, "Predictors of 12-week remission in a nationwide cohort of people with depressive disorders: the CRESCEND study", Hum Psychopharmacol, 26, pp.41~50 (2011)
- Kim JM, "Improvement within 2 weeks and later treatment outcomes in patients with depressive disorders: the CRESCEND study", J Affect Disord, 129, pp.183~190 (2011)
- Guo T, "Measurement-based care versus standard care for major depression: a randomized controlled trial with blind raters", Am J Psychiatry, 172, pp.1004~1013 (2015)
- Kim JM, "Short and long-term treatment outcomes of stepwise psychopharmacotherapy based on early clinical decision in patients with depressive disorders", J Affect Disord, 274, pp.315~325 (2020)
- Ha-Yeon Kim, "Predictors of Remission in Acute and Continuation Treatment of Depressive Disorders", Clinical Psychopharmacology and Neuroscience, 19(3), pp.490~497 (2021), 대한정신약물학회[DOI]
- Hee-Ju Kang, "The MAKE Biomarker Discovery for Enhancing anTidepressant Treatment Effect and Response (MAKE BETTER) Study: Design and Methodology", PSYCHIATRY INVESTIGATION, 15(5), pp.538~545 (2018), 대한신경정신의학회
- American Psychiatric Association, "Diagnostic and statistical manual of mental disorders (DSM‐IV)" (1994), American Psychiatric Association
- American Psychiatric Association, "Diagnostic and statistical manual of mental disorders (DSM-5)" (2013), American Psychiatric Association
- Hamilton M, "A rating scale for depression", J Neurol Neurosurg Psychiatry, 23, pp.56~62 (1960)
- Zigmond AS, "The hospital anxiety and depression scale", Acta Psychiatr Scand, 67, pp.361~370 (1983)
- Rabin R, "EQ-5D: a measure of health status from the EuroQol group", Ann Med, 33, pp.337~343 (2001)
- Sarason IG, "Assessing the impact of life changes:development of the life experiences survey", J Consult Clin Psychol, 46, pp.932~946 (1978)
- Cohen S, "A global measure of perceived stress", J Health Soc Behav, 24, pp.385~396 (1983)
- Connor KM, "Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC)", Depress Anxiety, 18, pp.76~82 (2003)
- Zimet GD, "The multidimensional scale of perceived social support", J Pers Assess, 52, pp.30~41 (1988)
- Overall JE, "The brief psychiatric rating scale", Psychol Rep, 10, pp.799~812 (1962)
- Romera I, "Residual symptoms and functioning in depression, does the type of residual symptom matter? A post-hoc analysis", BMC Psychiatry, 13, pp.51~ (2013)
- Sheehan DV, "Restoring function in major depressive disorder: a systematic review", J Affect Disord, 215, pp.299~313 (2017)
- Yeh MY, "Clinical predictors associated with full remission versus episode of major depressive disorder outpatients:the experience at a teaching hospital in Taiwan", BMC Psychiatry, 14, pp.273~ (2014)
- Brugha TS, "Predicting the short-term outcome of first episodes and recurrences of clinical depression: a prospective study of life events, difficulties, and social support networks", J Clin Psychiatry, 58, pp.298~306 (1997)
- Kim JM, "Stressful events, stress perception and treatment outcomes in patients with depressive disorders: the CRESCEND study", J Affect Disord, 133, pp.528~536 (2011)
- Fekadu A, "Prediction of longer-term outcome of treatment-resistant depression in tertiary care", Br J Psychiatry, 201, pp.369~375 (2012)
- Gariépy G, "Social support and protection from depression: systematic review of current findings in Western countries", Br J Psychiatry, 209, pp.284~293 (2016)
- Mann JJ, "Candidate endophenotypes for genetic studies of suicidal behavior", Biol Psychiatry, 65, pp.556~563 (2009)