基于症状的表型在晚年抑郁症的认知,残疾和治疗结果的影响
Katherin Sudol1, Catherine Conway1, Sarah M Szymkowicz1
1The Vanderbilt Center for Cognitive Medicine (KS, CC, SMS, DE, WDT), Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN.
概括
晚年抑郁症症状如冷漠,无情,疲劳和失眠等聚集在一起,与残疾相关. 埃斯基塔洛普拉姆 (escitalopram) 对这些晚年抑郁症症状的改善相比安慰剂的改善有限.
科学领域:
- 老年精神病学是一门精神病学专业.
- 临床心理学 临床心理学
- 神经科学是一个神经科学.
背景情况:
- 晚年抑郁症在症状,功能障碍和治疗结果方面存在显著的异质性.
- 了解症状集群对于为患有抑郁症的老年人定制干预措施至关重要.
研究的目的:
- 调查自我报告的症状严重程度表型与晚年抑郁症临床表现之间的关联.
- 为了确定症状表型是否预测治疗对埃斯基塔洛普拉姆的反应.
- 在为期8周的埃斯基塔洛普拉姆试验中检查症状改善.
主要方法:
- 89名患有抑郁症的老年人接受了基线评估,包括神经心理测试和症状/残疾尺度.
- 参与者参加了一个为期8周的,双盲,安慰剂对照的ESCITALOPRAM试验.
- 症状严重程度得分被分为表型,并分析了它们与基线测量和治疗反应的相关性.
主要成果:
- apathia/anhedonia和疲劳/失眠严重程度是相关的,并与更大的残疾相关.
- 疲劳/失眠与较慢的处理速度相关;反/担心与较差的情节性记忆相关.
- 没有症状表型预测了埃斯基塔洛普拉姆的整体反应;埃斯基塔洛普拉姆在大多数症状中,除了担忧和反之外,对安慰剂的益处很小.
结论:
- 症状表型可能会揭示晚年抑郁症的不同临床表现.
- 与安慰剂相比,埃斯基塔洛普拉姆在大多数评估的表型症状中表现出有限的疗效.
- 需要进一步的研究来将症状表型与长期结果联系起来,并确定特定症状集群的最佳治疗方法.
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