痛苦的身体症状和抗抑郁药治疗结果在抑郁症:一个系统的审查和元分析
Jia Jia Liu1, Xiao Huang2, Yan-Ping Bao3
1School of Nursing, Peking University, Beijing, China.
Molecular psychiatry
|March 14, 2024
概括
大型抑郁症 (MDD) 中的痛苦的身体症状 (PPS) 与抗抑郁药治疗结果较差有关. 在抑郁症的同时管理疼痛可能会提高治疗的有效性.
科学领域:
- 精神病学和心理健康 精神病学和心理健康
- 疼痛医学 医学 疼痛医学
- 临床流行病学 临床流行病学
背景情况:
- 疼痛的身体症状 (PPS) 在被诊断为患有严重抑郁症 (MDD) 的患者中很常见.
- PPS的存在可能会对抗抑郁药治疗MDD的有效性产生负面影响.
研究的目的:
- 调查MDD患者的基线疼痛水平和治疗结果之间的关联.
- 为了确定更高的疼痛严重程度或干扰是否预测抗抑郁药物的反应较差.
主要方法:
- 在PubMed,Embase和Cochrane图书馆数据库中进行了系统的文献搜索,截至2023年2月.
- 包括的研究报告了MDD患者的治疗前疼痛指标,按治疗反应或缓解进行分类.
- 随机效应元分析被用来计算响应者和非响应者之间的疼痛水平的影响大小.
主要成果:
- 对20项研究的元分析显示,基线疼痛严重程度和干扰MDD治疗不响应者显着更高.
- 预后性精神病的存在与较差的治疗反应 (OR=1.46) 和非缓解 (OR=1.70) 显著相关.
- 较高的基线疼痛严重程度也与MDD患者的非缓解有关 (Hedge的g=0.27).
结论:
- 这一元分析表明,在MDD中,痛苦的身体症状和抗抑郁药治疗结果之间存在负面关联.
- 抑郁症患者疼痛症状的有效管理可能会增强抗抑郁药疗法的有效性.
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