SERDAR BULUT, Mehmet AK, Doğan BULUT, Türker TÜRKER, Adnan CANSEVER, Hamdullah AYDIN

Antidepresan tedaviye yanıtı etkileyen klinik özellikler: Doğal izleme çalışması

Amaç: Bu çalışmanın amacı depresyonda antidepresan tedaviye yanıt veren ile vermeyen olguların klinik özelliklerini karşılaştırarak tedaviye yanıtı etkileyen özelliklerin tanımlanmasıdır. Yöntem: Çalışmaya, GATA Psikiyatri Kliniğine başvuran hastalar içinden depresyon tanısı konup antidepresan tedavi düzenlenenler alınmıştır. Görüşmelerde sosyodemografik veri toplama formu, SCID-I, SCID-II, HAM-D ölçekleri kullanılmıştır. Tedavinin ikinci, dördüncüaltıncı haftalarında HAM-D ölçeği yeniden uygulanmıştır. Altıncı haftada HAM-D puanlarında %50 ve daha fazla azalma tedaviye yanıt olarak değerlendirilmiş, tedaviye yanıt veren ve vermeyen olgular klinik özellikler açısından karşılaştırılmıştır. Bulgular: Altıncı haftanın sonunda 87 depresyon olgusunun 73ü (%83.9) tedaviye yanıt vermiş, 14ü (%16.1) yanıt vermemiştir. Tedaviye yanıt vermeyen olgularda verenlere göre depresyonun daha şiddetli olduğu, komorbid eksen-I ve eksen-II tanılarının daha fazla olduğu belirlenmiştir. Gruplar arasında eşlik eden fiziksel hastalık bulunması, depresif nöbet sayısı ve hastalığın başlangıç yaşı açısından anlamlı fark bulunmamıştır. Sonuç: Çalış- manın sonunda antidepresan tedaviye yanıtı olumsuz etkileyen klinik özellikler olarak depresyonun şiddetli olması, komorbid eksen-I ve eksen-II tanılarının bulunması tespit edilmiştir. Bu klinik özelliklerin başlangıçta değerlendirilip antidepresan tedaviye kötü yanıt verebileceği göz önünde bulundurularak ek tedavi seçeneklerinin de göz önünde bulundurulmasının önemli olduğu düşünülmüştür.

Clinical features that affect the response to the antidepresstreatment: a naturalistic follow up study

Objective: The aim of this study is to define the clinical features that affect the antidepressant treatment response by comparing the cases that responded and did not respond to the antidepressant treatment. Methods: Among the patients admitted to the GATA Department of Psychiatry, the ones who were diagnosed with major depressive disorder and have given antidepressant treatment were included to the study. Sociodemographic information form, SCID-I, SCID-II, and Hamilton Depression Scale (HAM-D) were used for the initial assessment. HAM-D scale was repeated at the second, fourth and sixth weeks of the treatment. The cases, whose HAM-D scale scores were reduced 50% or more, were defined as the responders to antidepressant treatment and were compared with non-responders based on their clinical features. Results: At the end of the sixth week of the treatment, 73 (83.9%) of the 87 depression cases responded to the treatment and 14 (16.1%) of them did not respond. The severity of the depression was higher and there were more comorbid Axis-I and Axis-II diagnoses in the non-responders group compared to the responders group. There were no significant differences between the two groups in terms of the comorbid physical illnesses, the number of depression episodes and the age of onset of the disease. Conclusion: As a result, the severity of the depression and the comorbidity of Axis-I and Axis-II diagnoses were determined as the clinical features which negatively affect the response to the antidepressant treatment. These clinical features could be evaluated as possible indicators of poorer outcomes of antidepressant treatments and therefore considering other treatment options might be important at the beginning of the treatment. <<<<<<<<<<<<<<<<<<<<<

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