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首页> 外文期刊>Psychological medicine >Remission and relapse after the first hospital admission in psychotic depression: a 4-year naturalistic follow-up
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Remission and relapse after the first hospital admission in psychotic depression: a 4-year naturalistic follow-up

机译：精神病性抑郁症首次入院后的缓解和复发：4年的自然随访

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Background. Few studies have examined the course of illness among severely depressed patients ascertained at first hospitalization. Using data from the Suffolk County Mental Health Project (SCMHP), we investigated the times to and predictors of the first full remission and the first relapse during a 4-year period in a first-admission cohort with major depressive disorder (MDD) with psychotic features.rnMethod. The cohort included 87 county-wide, first-admission patients with a longitudinal consensus diagnosis of MDD with psychotic features who were systematically followed over a 4-year period. We examined the associations of background, clinical and treatment factors, and time-varying indices of antidepressant (AD) and antipsychotic (AP) medication use to time to remission and relapse using Cox regression.rnResults. By the 4-year follow-up, 60 respondents (69.0%) had achieved a period of full remission (median time of 22 weeks among remitters and 54 weeks in the full sample). In the multivariable analysis, longer time to remission was associated with longer latency between initial episode and hospitalization, lower pre-hospital Global Assessment of Functioning (GAF) score, and lack of insurance, but not use of medication. Twenty-six remitters (43.3%) relapsed (median time of 50 weeks among those who relapsed and 192 weeks among all remitters). None of the risk factors or time-varying medication variables was significantly associated with time to relapse.rnConclusion. Only two-thirds of the sample had at least one full remission by 4 years, and almost half of them subsequently relapsed. Poorer pre-hospital resources predicted remission but not relapse. Medication use over the follow-up was not associated with remission or relapse.
机译：背景。很少有研究检查初次住院时确定的严重抑郁症患者的病程。利用萨福克郡精神卫生项目（SCMHP）的数据，我们调查了首次入院的重度抑郁症伴精神病患者在4年内首次完全缓解和第一次复发的时间及预测因素features.rnMethod。该队列包括87名全县首次入院的患者，他们对MDD具有精神病学特征进行纵向共识诊断，并在4年内进行了系统随访。我们使用Cox回归分析了背景，临床和治疗因素以及抗抑郁药（AD）和抗精神病药（AP）的使用随时间变化的指标与缓解和复发时间的关系。通过4年的随访，有60位受访者（69.0％）达到了完全缓解的时期（在缓解者中，中间时间为22周，在整个样本中为54周）。在多变量分析中，较长的缓解时间与初始发作和住院之间的潜伏期较长，院前总体功能评估（GAF）评分较低以及缺乏保险但不使用药物有关。复发者有26位（43.3％）（复发者中位时间为50周，所有缓解者中位时间为192周）。没有危险因素或时变药物变量与复发时间显着相关。样本中只有三分之二到4年至少达到了完全缓解，随后几乎有一半复发了。较差的院前资源预计会缓解，但不会复发。随访期间的药物使用与缓解或复发无关。

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