Background: It remains unclear whether or not a positive family history of affective disorders predicts the effectiveness of antidepressant treatment of depression.
Aims: Assess the relationship of a family history of affective disorders to the efficacy of duloxetine in the treatment of depressive disorder.
Methods: Seventy-seven patients with depressive disorder (as defined by the 10th edition of the International Classification of Diseases, ICD-10) were enrolled in the study and treated with standard doses of duloxetine for 12 weeks. Among these patients 37 had a family history of affective disorder in first-degree relatives and 40 did not. The Hamilton Depression rating scale (HAMD-17), Hamilton Anxiety rating scale (HAMA), Side Effects Rating Scale (SERS), Snaith-Hamilton Pleasure Scale (SHAPS), and Beck Depression Inventory (BDI) were assessed at baseline and at the end of the 2(nd), 4(th), 6(th), 8(th), and 12(th) week after enrollment. Repeated measures analysis of variance and logistic regression were used to analyze the association between a family history of affective disorders and the efficacy of duloxetine.
Results: Patients with a positive family history of affective disorders had an earlier age of onset, a longer duration of illness, a higher level of psychic anxiety, and more prominent anhedonia. Repeated measures analysis of variance showed a significant improvement in the severity of depression over the 12 weeks but no differences in the magnitude or speed of improvement between the two groups. Treatment was considered effective (i.e., drop in baseline HAMD-17 total score of ≥50%) in 75.7% of those with a family history of affective disorders and in 77.5% of those without a family history (X(2)=0.04, p=0.850).
Conclusions: Family history of affective disorders is not associated with the effectiveness of duloxetine in the acute treatment of depressive disorder.
背景: 阳性情感障碍家族史能否预测抗抑郁药疗效尚不清楚。.
目的: 评估情感障碍家族史与度洛西汀治疗抑郁症的疗效之间的相关性。.
方法: 研究纳入符合国际疾病分类第10版中抑郁症定义的77例患者，采用标准剂量的度洛西汀治疗12周。其中37例患者有情感障碍家族史（一级亲属中），另外40例家族史阴性。采用汉密尔顿抑郁量表 (Hamilton Depression rating scale, HAMD-17)、汉密尔顿焦虑量表 (Hamilton Anxiety rating scale, HAMA)、抗抑郁药副反应量表 (Side Effects Rating Scale, SERS)、斯奈思-汉密尔顿快感量表 (Snaith-Hamilton Pleasure Scale, SHAPS) 和贝克抑郁自评量表 (Beck Depression Inventory, BDI) 在基线与纳入研究后第2、4、6、8、12周末对患者进行评估。采用重复测量方差分析和logistic回归分析情感障碍家族史与度洛西汀疗效之间的相关性。.
结果: 情感障碍阳性家族史的患者发病较早，病程较长，精神性焦虑水平更高，而且快感缺乏更加突出。重复测量方差分析显示经过12周治疗抑郁症严重程度显著改善，但两组之间的改善幅度或速度没有显著差异。情感障碍家族史阳性的患者中有75.7％治疗有效（即 HAMD-17 总分较基线下降 ≥50%），而家族史阴性的患者有77.5％有效 (X2=0.04, p=0.850)。.
结论: 情感障碍家族史与度洛西汀对抑郁症的急性期治疗的疗效不相关。.
中文全文: 本文全文中文版从2015年10月26日起在http://dx.doi.org/10.11919/j.issn.1002-0829.215080可供免费阅览下载.
Keywords: China; depressive disorders; duloxetine; family history.