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首页> 外文期刊>International clinical psychopharmacology >Functional impairment in patients with major depression in clinical remission: results from the VIVAL-D-Rem, a nationwide, naturalistic, cross-sectional survey
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Functional impairment in patients with major depression in clinical remission: results from the VIVAL-D-Rem, a nationwide, naturalistic, cross-sectional survey

机译：患有严重抑郁症的临床缓解患者的功能障碍：VIVAL-D-Rem（全国性，自然主义，横断面调查）的结果

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摘要

In recent years, the standard for successful treatment of major depression has switched from response to remission; however, little is known about patients who have achieved remission, but still have some residual symptoms and whether they regain previous levels of functioning. In a large, nationwide, cross-sectional, naturalistic survey (VIVAL-D) of 907 patients with major depression treated with a new course of an antidepressant in 41 Italian community psychiatric centers, patients with a Hamilton Rating Scale for Depression, 17-item version (HAM-D-17) score up to 14 were selected (n = 499). Of these, 169 were considered to be in remission (HAM-D-17 <= 7) and the other 330 to be mildly depressed. Their level of functioning was evaluated using the SF-12. Only a few (3%) patients in remission were completely symptom free; most were affected by residual symptoms. Patients in remission had better SF-12 scores than those with mild depression, but their functioning was significantly worse than general population norms. In the logistic regression analysis, the HAM-D-17 total score and individual items were predictive of poor functioning. Analysis of sensitivity and specificity values showed that a lower cut-off score (4/5) of the HAM-D-17 scale was best for predicting poor performance so that a reconsideration of the usual cut-off for remission of 7/8 for HAM-D-17 seems overdue. Copyright (C) 2015 Wolters Kluwer Health, Inc. All rights reserved.
机译：近年来，成功治疗重度抑郁症的标准已从反应转变为缓解。然而，对于已经获得缓解但仍具有一些残留症状以及他们是否恢复了以前的功能水平的患者知之甚少。在一项大型的全国性横断面自然调查（VIVAL-D）中，对41个意大利社区精神病学中心的907名重度抑郁症患者接受了新疗程的抗抑郁药治疗后，他们使用了汉密尔顿抑郁量表（17）版本（HAM-D-17）得分最高为14（n = 499）。其中有169例已缓解（HAM-D-17 <= 7），其余330例为轻度抑郁。使用SF-12评估了它们的功能水平。只有少数（3％）缓解的患者完全没有症状;大多数受残留症状的影响。缓解期患者的SF-12评分比轻度抑郁症患者好，但其功能明显低于一般人群标准。在逻辑回归分析中，HAM-D-17总分和单个项目可预测功能不良。敏感性和特异性值的分析表明，HAM-D-17量表的较低分值（4/5）最适合预测不良表现，因此，重新考虑通常的分界值可使7/8的缓解率降低。 HAM-D-17似乎已经过期。版权所有（C）2015 Wolters Kluwer Health，Inc.保留所有权利。

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