Mortality and Suicide Risk in Treatment-Resistant Depression An Observational Study of the Long-Term Impact of Intervention 英文参考文献.docVIP

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Mortality and Suicide Risk in Treatment-Resistant Depression An Observational Study of the Long-Term Impact of Intervention 英文参考文献.doc

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Mortality and Suicide Risk in Treatment-Resistant Depression An Observational Study of the Long-Term Impact of Intervention 英文参考文献

MortalityandSuicideRiskinTreatment-Resistant Depression:AnObservationalStudyoftheLong-Term ImpactofIntervention BryanOlin1*,AmaraK.Jayewardene1,MarkBunker1,FranciscoMoreno2 1Cyberonics,Inc,Houston,Texas,UnitedStatesofAmerica,2DepartmentofPsychiatry,TheUniversityofArizona,Tucson,Arizona,UnitedStatesofAmerica Abstract Majordepressivedisorderisacommonglobaldiseasethatcausesasignificantsocietalburden.Mostinterventionalstudies ofdepressionprovidealimitedassessmentoftheinterventionsonmortalityandsuiciderisks.Thisstudyutilizesdatafrom anobservationalregistryofpatientswithmajordepressivedisordertodeterminetheimpactofintervention(vagusnerve stimulation or standard pharmacological/non-pharmacological therapy) and a latent factor, patient trajectory toward response,onmortality,suicideandsuicidalideation.Atotalof636patientswereavailableforanintent-to-treatanalysisof all-cause mortality, suicide and suicidal ideation. Patients treated with vagus nerve stimulation in addition to standard therapies experienced lower, but not statistically significant, all-cause mortality (vagus nerve stimulation 4.93 per 1,000 person-yearsvs.10.02per1,000patientyearsfortreatmentasusual)andsuiciderates(vagusnervestimulation0.88per 1,000 person-years vs. 1.61 per 1,000 patient years for treatment as usual). Treatment with vagus nerve stimulation producedastatisticallylowerrelativeriskofsuicidalideation0.80,95%confidenceinterval(0.68,0.95).Further,patientsthat respondedtoeithertreatmentsawa51%reductioninrelativeriskofsuicidalbehavior;relativeriskand95%confidence interval of 0.49 (0.41,0.58). In summary, we find that treatment with adjunctive vagus nerve stimulation can potentially lowertheriskofall-causemortality,suicideandsuicideattempts. Citation:OlinB,JayewardeneAK,BunkerM,MorenoF(2012)MortalityandSuicideRiskinTreatment-ResistantDepression:AnObservationalStudyoftheLong- TermImpactofIntervention.PLoSONE7(10):e48002.doi:10.1371/journal.pone.0048002 Editor:LuLin,PekingUniversity,China ReceivedMay31,2