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阿戈美拉汀治疗抑郁障碍患者快感缺失的疗效研究
曾俊秦春莉韩树红
()
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目的 评价阿戈美拉汀治疗抑郁障碍患者快感缺失的疗效。方法 本研究共纳入58 例抑郁障碍患者,所有受试者接受阿戈美拉汀(25~50 mg/d,可变剂量)治疗8 周。采用Snaith 汉密尔 顿快感缺失量表(SHAPS)、蒙哥马利抑郁评定量表(MADRS)评估患者抑郁及快感缺失的情况,采 用Sheehan 残疾量表(SDS)和世界卫生组织的5 项健康指数(WHO-5)量表评估患者功能损害和生 活质量。结果 (1)阿戈美拉汀治疗8 周后,SHAPS 终点的临床应答和缓解率分别为64.71%(33/51)和 58.82%(30/51),SHAPS 和MADRS 快感缺失因子分较基线显著改善(P< 0.01)。(2)回归分析显示,性别、 首发年龄和精神疾病家族史影响患者快感缺失的缓解。(3)治疗8 周末,SHAPS 和MADRS 快感缺失因 子分较基线的改善,与WHO-5 和SDS 评分较基线的改善显著相关(P< 0.01)。(4)中介分析显示,快感缺 失的改善可调节抑郁症状严重程度和社会功能改善之间的关联。结论 阿戈美拉汀对抑郁症快感缺失 疗效显著,且快感缺失的改善是抑郁症状与社会功能改善之间强有力的中介。
基金项目:
Efficacy of agomelatin in the treatment of anhedonia in patients with depressive disorders
Zeng Jun, Qin Chunli, Han Shuhong
()
Abstract:
Objective To evaluate the effectiveness of agomelatine in the treatment of anhedonia in patients with depressive disorders. Methods A total of 58 subjects were included in the study. All patients were treated with agomelatin( 25-50 mg/d, variable doses) for 8 weeks. Snaith-Hamilton Pleasure Scale( SHAPS) and Montgomery-Åsberg Depression Rating Scale( MADRS) were used to evaluate patients' depression and anhedonia, and the Sheehan Disability Scale( SDS) and the 5-Item World Health Organization Well-Being Index (WHO-5) were used to evaluate patients' functional impairment and quality of life. Results (1)After 8 weeks of treatment with agomelatin, the clinical response and remission rates of SHAPS were 64.71%(33/51) and 58.82% (30/51). The SHAPS and MADRS anhedonia factors after the treatment were significantly improved compared to baseline( P < 0.01).( 2)Regression analysis showed that gender, first-episode age and family history of mental illness affected the improvement of anhedonia.( 3)At the end of 8 weeks of treatment, the improvement of SHAPS and MADRS anhedonia factor was significantly correlated with the improvement of WHO-5 and SDS scores( P<0.01).( 4)Mediational effect analysis showed that the improvement in anhedonia mediated the relationship between depressive severity and the improvement of social functions. Conclusions Agomelatin has a significant effect on anhedonia in patients with depressive disorder, and the improvement of anhedonia is a powerful mediator for the relationship between depressive symptoms and the improvement of social functions.

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