关于意大利治疗耐药抑郁症的临床管理的全国共识:德尔菲小组
Giuseppe Maina1,2, Marina Adami3, Giuseppe Ascione3
1Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy.
Annals of general psychiatry
|November 23, 2023
概括
意大利的治疗耐药性抑郁症 (TRD) 管理显示出显著的变化. 专家们达成共识,认为埃斯基坦胺鼻喷剂是关键的治疗选择,需要标准化TRD策略.
科学领域:
- 精神病学是一个精神病学.
- 临床药理学 临床药理学
背景情况:
- 耐治疗抑郁症 (TRD) 给个人和社会带来了巨大的负担.
- 目前的TRD管理缺乏标准化的指导方针,导致实践变化.
- 较新的快速起作用的治疗方法,如埃斯凯他明鼻雾剂,需要了解当前的临床途径.
研究的目的:
- 在意大利精神病医生之间就TRD的临床特征和治疗途径达成共识.
- 评估意大利常规临床实践中TRD管理的现状.
- 评价专家意见的作用,在TRD治疗中使用埃斯基坦胺鼻喷雾.
主要方法:
- 60名经验丰富的意大利精神病医生接受了包含17个陈述的Delphi问卷.
- 通过基于网络的平台采集了答案,使用7点的利克特等级.
- 第二轮的答案包含了第一轮的四分位数间范围数据,用于使用Stata 16.1.1.进行分析.
主要成果:
- 在17个声明中,在8个声明中达成了高度共识 (超过75%的同意).
- 对于4个陈述,观察到适度的同意,回复集中在利克尔特尺度的中点.
- 对于5个陈述,人们注意到共识低和犹不决,这表明意见异质.
结论:
- 在意大利各地的TRD患者管理中存在显著的异质性,突出了对标准化策略的需求.
- 高度的共识支持和/或抗精神病药物作为增强疗法和长期维护的必要性.
- 埃斯凯特胺鼻喷剂被确定为TRD的首选选择,在门诊环境中可行性得到了患者教育的支持.
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