Residual symptoms and functioning in depression, does the type of residual symptom matter A post-hoc analysis 英文参考文献.docVIP

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Residual symptoms and functioning in depression, does the type of residual symptom matter A post-hoc analysis 英文参考文献.doc

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Residual symptoms and functioning in depression, does the type of residual symptom matter A post-hoc analysis 英文参考文献

Romeraetal.BMCPsychiatry2013,13:51 /1471-244X/13/51 RESEARCH ARTICLE OpenAccess Residualsymptomsandfunctioningin depression,doesthetypeofresidualsymptom matter?Apost-hocanalysis IreneRomera1,2*,VíctorPérez3,AntonioCiudad1,LuisCaballero4,MiguelRoca5,PepaPolavieja1 andInmaculadaGilaberte1 Abstract Background:Thedegreestowhichresidualsymptomsinmajordepressivedisorder(MDD)adverselyaffectpatient functioningisnotknown.Thispost-hocanalysisexploredtheassociationbetweendifferentresidualsymptomsand patientfunctioning. Methods:PatientswithMDDwhoresponded(≥50%onthe17-itemHamiltonRatingScaleforDepression; HAMD-17)after3monthsoftreatment(624/930)wereincluded.Residualcoremood-symptoms(HAMD-17core symptomsubscale≥1),residualinsomnia-symptoms(HAMD-17sleepsubscale≥1),residualanxiety-symptoms (HAMD-17-anxietysubscale≥1),residualsomatic-symptoms(HAMD-17Item13≥1),pain(VisualAnalogueScale ≥30),andfunctioningwereassessedafter3monthstreatment.Astepwiselogisticregressionmodelwithnormal functioning(SocialandOccupationalFunctioningAssessmentScale≥80)asthedependentvariablewasused. Results:After3months,59.5%ofpatients(371/624)achievednormalfunctioningand66.0%(412/624)werein remission.Residualsymptomprevalencewas:coremoodsymptoms72%;insomnia63%;anxiety78%;andsomatic symptoms41%.Painreportedin18%.Factorsassociatedwithnormalfunctioningwereabsenceofcoremood symptoms(oddsratio[OR]8.7;95%confidenceinterval[CI],4.6–16.7),absenceofinsomniasymptoms(OR1.8;95% CI,1.2–2.7),episodelength(4–24weeksvs.≥24weeks[OR2.0;95%CI,1.1–3.6])andbetterbaselinefunctioning(OR 1.0;95%CI,1.0–1.1).Asignificantinteractionbetweenresidualanxietysymptomsandpainwasfound(p=0.0080). Conclusions:Differentresidualsymptomsareassociatedtodifferentdegreeswithpatientfunctioning.Toachieve normalfunctioning,specificresidualsymptomsdomainsmightbetargetedfortreatment. Keywords:Residualsymptoms,Majordepression,Functioning Background about the role of specific residual symptom domains, Residual symptoms of depression cause significant suc