• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>The journal of clinical psychiatry >The Effect of Duloxetine on Painful Physical Symptoms in Depressed Patients: Do Improvements in These Symptoms Result in Higher Remission Rates?
【24h】

The Effect of Duloxetine on Painful Physical Symptoms in Depressed Patients: Do Improvements in These Symptoms Result in Higher Remission Rates?

机译：度洛西汀对抑郁症患者的痛苦身体症状的影响：这些症状的改善是否会导致较高的缓解率？

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

BACKGROUND: Depression is a chronic disease consisting of emotional/psychological and physical symptoms. Emotional symptoms have been shown to respond to currently available antidepressants; however, physical symptoms may not be as responsive. It was hypothesized that resolution of both psychological and physical symptoms of depression would predict a higher percentage of patients achieving remission. METHOD: Efficacy data were pooled from 2 identical, but independent, 9-week randomized, double-blind clinical trials of duloxetine 60 mg q.d. (N = 251) and placebo (N = 261). All patients met diagnostic criteria for DSM-IV major depressive disorder, which was confirmed by the Mini-International Neuropsychiatric Interview. Efficacy measures included the 17-item Hamilton Rating Scale for Depression (HAM-D-17) total score, the HAM-D-17 Maier subscale, the Clinical Global Impressions-Severity of Illness (CGI-S) scale, the Patient Global Impression of Improvement (PGI-I) scale, the Somatic Symptom Inventory, the Quality of Life in Depression Scale, and Visual Analog Scales (VAS) for pain (overall pain, headaches, back pain, shoulder pain, interference with daily activities, and time in pain while awake). RESULTS: Duloxetine-treated patients demonstrated significantly greater improvement in overall pain (p =.016), back pain (p =.002), and shoulder pain (p =.021) at week 9 compared with patients receiving placebo. When treatment effects were pooled over all visits, patients receiving duloxetine, 60 mg q.d., exhibited significantly greater improvement than placebo-treated patients in 5 of the 6 assessed VAS pain measures. Approximately 50% of the improvement in overall pain was independent of improvement in HAM-D-17 total score. Assuming the same level of improvement in core emotional symptoms of depression (Maier subscale), improvement in overall pain severity was associated with higher estimated probabilities of remission (p <.001). The week 9 means for VAS overall pain severity were 13.0 for remitters (last observed value for HAM-D-17 was /= 50%) was twice that observed for pain nonresponders (36.2% vs. 17.8%, p <.001). Greater improvements in pain outcomes were associated with more favorable endpoint outcomes on the CGI-S and PGI-I scales. In addition, early favorable responses in VAS overall pain severity were associated with favorable endpoint outcomes. CONCLUSIONS: Treatment with duloxetine, 60 mg q.d., significantly reduced pain compared with placebo. Improvements in pain severity were attributable equally to the direct effect of duloxetine and to associated changes in depression severity. Improvement in painful physical symptoms was associated with higher remission rates even after accounting for improvement in core emotional symptoms.
机译：背景：抑郁症是一种由情绪/心理和身体症状组成的慢性疾病。情绪症状已显示出对目前可用的抗抑郁药有反应;但是，身体症状可能没有那么快。据推测，抑郁症的心理和生理症状的缓解将预测获得缓解的患者比例更高。方法：功效数据来自2个相同但独立的，为期9周的度洛西汀60 mg q.d的随机，双盲临床试验。 （N = 251）和安慰剂（N = 261）。所有患者均符合DSM-IV重度抑郁症的诊断标准，该标准已由Mini-International Neuropsychiatric Interview确认。疗效测量包括17个项的汉密尔顿抑郁量表（HAM-D-17）总分，HAM-D-17 Maier子量表，临床总体印象-疾病严重程度（CGI-S）量表，患者总体印象改善（PGI-I）量表，躯体症状量表，抑郁症生活质量量表和视觉模拟量表（VAS）以评估疼痛（总体疼痛，头痛，背痛，肩痛，干扰日常活动和时间）在清醒的痛苦中）。结果：与接受安慰剂的患者相比，用度洛西汀治疗的患者在第9周的总体疼痛（p = .016），背部疼痛（p = .002）和肩部疼痛（p = .021）的改善明显更大。在所有就诊中汇总治疗效果时，在6项评估的VAS疼痛措施中，有5项接受每日60毫克度洛西汀治疗的患者比安慰剂治疗的患者表现出更大的改善。总体疼痛改善的约50％与HAM-D-17总评分的改善无关。假设抑郁的核心情感症状（Maier量表）的改善水平相同，则总体疼痛严重程度的改善与估计缓解的可能性更高（p <.001）。第9周，VAS总体疼痛严重程度的缓解者为13.0（HAM-D-17的最新观察值为 / = 50％）是疼痛缓解者的缓解率的两倍（36.2％vs. 17.8％，p <.001）。在CGI-S和PGI-I量表上，疼痛结局的更大改善与更有利的终点结局相关。此外，VAS总体疼痛严重程度的早期有利缓解与终点终点预后相关。结论：与安慰剂相比，用度洛西汀60 mg q.d.治疗可显着减轻疼痛。疼痛严重程度的改善可同归因于度洛西汀的直接作用以及抑郁症严重程度的相关变化。即使考虑到核心情绪症状的改善，痛苦的身体症状的改善也与较高的缓解率相关。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号