CAJ | 학술논문

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。
배경：양성정감장애가족사능부예측항억욱약료효상불청초。목적：평고정감장애가족사여도락서정치료억욱증적료효지간적상관성。방법：연구납입부합국제질병분류제10판중억욱증정의적77례환자，채용표준제량적도락서정치료12주。기중37례환자유정감장애가족사（일급친속중），령외40례가족사음성。채용한밀이돈억욱량표(Hamilton Depression rating scale, HAMD-17)、한밀이돈초필량표(Hamilton Anxiety rating scale, HAMA)、항억욱약부반응량표(Side Effects Rating Scale, SERS)、사내사-한밀이돈쾌감량표(Snaith-Hamilton Pleasure Scale, SHAPS)화패극억욱자평량표(Beck Depression Inventory, BDI)재기선여납입연구후제2、4、6、8、12주말대환자진행평고。채용중복측량방차분석화logistic회귀분석정감장애가족사여도락서정료효지간적상관성。결과：정감장애양성가족사적환자발병교조，병정교장，정신성초필수평경고，이차쾌감결핍경가돌출。중복측량방차분석현시경과12주치료억욱증엄중정도현저개선，단량조지간적개선폭도혹속도몰유현저차이。정감장애가족사양성적환자중유75.7％치료유효（즉HAMD-17총분교기선하강>50%），이가족사음성적환자유77.5％유효(X2=0.04,p=0.850)。결론：정감장애가족사여도락서정대억욱증적급성기치료적료효불상관。
Background:It remains unclear whether or not a posiitve family history of affecitve disorders predicts the effecitveness of anitdepressant treatment of depression. Aim: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 2nd, 4th, 6th, 8th, and 12th week atfer enrollment. Repeated measures analysis of variance and logisitc regression were used to analyze the associaiton between a family history of affecitve disorders and the effcacy of duloxeitne. Results:Paitents with a posiitve family history of affecitve disorders had an earlier age of onset, a longer duraiton of illness, a higher level of psychic anxiety, and more prominent anhedonia. Repeated measures analysis of variance showed a signiifcant 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 affecitve disorders and in 77.5% of those without a family history (X2=0.04,p=0.850). Conclusion:Family history of affecitve disorders is not associated with the effecitveness of duloxeitne in the acute treatment of depressive disorder.