选择性血清素再吸收抑制剂随机对照试验中的多病症表示:对已发表的试验进行系统分析
Dawn Hei Lum1, Mandy Man Choi1, Jacky On Hei Cheung1
1Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
Journal of affective disorders
|October 14, 2023
概括
大多数选择性血清素再吸收抑制剂 (SSRI) 试验都排除了多病症患者. 未来的研究应该包括这些患者,以更好地了解复杂健康状况中的治疗效果.
科学领域:
- 临床心理学 临床心理学
- 精神病学是一个精神病学.
- 流行病学 流行病学
背景情况:
- 越来越多的证据表明,多病症和抑郁症之间存在双向联系.
- 越来越多的人被诊断出患有这两种疾病.
- 这凸显了需要检查临床研究中多病症如何解决的问题.
研究的目的:
- 调查选择性血清素再吸收抑制剂 (SSRI) 在随机对照试验 (RCT) 中多病症的表现.
- 分析研究如何包括或排除多种健康状况的患者.
- 确定与SSRI试验中多病症的包含或排除相关的因素.
主要方法:
- 在主要数据库 (PubMed,Cochrane,PsycINFO,EMBASE) 中对2011年以来发表的RCT进行了全面的文献搜索.
- 多种疾病的表现被归类为"包含"或"排除".
- 包括多病症在内的研究根据分析类型进一步分类:"多变量调整"或"效果修改/分层".
主要成果:
- 在包括的183项试验中,58% (106项研究) 排除了多病症参与者.
- 只有四项研究进行了多变量调整或对多病症的效果修改分析.
- 来自亚洲的研究表明,与北美相比,多病症排除的几率更高.
结论:
- 显著的一小部分SSRIRCT在设计中未能考虑多病症.
- 鉴于精神健康问题和多种慢性疾病的患病率不断上升,未来的研究必须纳入多种疾病.
- 这将有助于更好地了解SSRI在不同患者群体中的有效性和安全性.
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