缓解青少年抑郁症的顺序治疗替代方案 (STAR-AD):一个多中心的开放标签随机对照试验协议
Yuqian He1, Xieyu Gan2, Xuemei Li1
1Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuzhong District, Chongqing, China.
BMC psychiatry
|October 27, 2023
概括
这项研究比较了fluoxetine与青少年抑郁症的认知行为疗法 (CBT). 它还测试了对不响应者更换或增加药物,指导重大抑郁障碍 (MDD) 的治疗决策.
科学领域:
- 儿童和青少年精神病学 儿童和青少年精神病学
- 临床心理学 临床心理学
- 药物治疗 药物治疗
背景情况:
- 青少年主要抑郁症 (MDD) 由于治疗成功率低,因此存在重大挑战.
- 青少年MDD的最佳初始和后续治疗策略仍在研究中.
- 在初始疗法无效时,需要了解首选的治疗调整.
研究的目的:
- 为了比较fluoxetine单一治疗与fluoxetine与认知行为疗法 (CBT) 结合的疗效,作为青少年MDD的初始治疗方法.
- 评估治疗转换或增强策略的有效性,对于最初治疗没有反应的患者.
- 为青少年MDD治疗的临床决策提供信息.
主要方法:
- 一个多中心的,开放的标签,顺序多重分配随机试验 (SMART) 设计超过16周.
- 第一个阶段:患者自行选择进入fluoxetine或fluoxetine + CBT组8周.
- 第2阶段:随机分配非响应塞特拉林,伏尔托克塞丁,杜洛克赛丁或增加阿里皮普拉,奥兰扎平或碳酸的患者.
主要成果:
- 主要结局:通过儿童抑郁症评分尺度修订 (CDRS-R) 评估的响应率.
- 二级结局:贝克抑郁症库存 (BDI) 的变化,儿童焦虑相关情绪障碍 (SCARED) 的检查和安全评估得分.
- 治疗后将评估治疗效果的长期可持续性.
结论:
- 这项研究旨在为选择青少年MDD的初始和后续治疗提供基于证据的指导.
- 这些发现将有助于临床医生优化对这一群体的治疗策略.
- 结果将有助于改善青少年抑郁症的治疗结果.
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