三例难治性抑郁症病例报告
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摘要
抑郁症是一种高患病率、高致残率及高自杀率的严重精神疾患,造成显著生活质量下降、工作能力受损、健康状况下降。在过去10年中,抗抑郁药物研究取得了突飞猛进的进展。然而,在临床上仍约有30%的抑郁症患者对抗抑郁药治疗无反应或反应不完全,成为难治性抑郁症(treatment-resi stant depression, TRD).由于难治性抑郁症的发病率较高、病程迁延、治疗缓解率低、治疗时间长,且多共患其他疾病,因而成为临床棘手的精神卫生问题。对于一些临床典型或特例的诊疗体会及时总结,有利于诊治的个体化,规范治疗方案。本文报道浙江大学医学院附属第一医院就诊的三例难治性抑郁症病人的诊断治疗过程并综述目前难治性抑郁症的治疗进展。
Depression is a highly prevalent and disabling condition associated with significant morbidity and mortality. Those affectedface significantly reduced quality of life, impairedability to work and poorer overall health. Although the therapeutic armamentarium available for clinicians treating depression patients has expanded substantially over the last decade, up to30%of depression patients show only partial or no response to an initial or multiple antidepressant treatments, eventually present with treatment-resistant depression (TRD). Because of higher incidence, prolonged course of treatment, low remission rate, and the great incidences of accompanied various comorbidities, TRD has still been described as a tough challenge for clinical staffs to overcome. The typical or specific case report may contribute to the standardized treatment programs and individualization with respect to the therapy of TRD. This case report is concerned with three hospitalized TRD patients as well as the diagnosis and treating processes in The First Affiliated Hospital of Zhejiang University and a minor review of the advancement up to date about the drug therapy of TRD is given.
Depression is a highly prevalent and disabling condition associated with significant morbidity and mortality. Those affectedface significantly reduced quality of life, impairedability to work and poorer overall health. Although the therapeutic armamentarium available for clinicians treating depression patients has expanded substantially over the last decade, up to30%of depression patients show only partial or no response to an initial or multiple antidepressant treatments, eventually present with treatment-resistant depression (TRD). Because of higher incidence, prolonged course of treatment, low remission rate, and the great incidences of accompanied various comorbidities, TRD has still been described as a tough challenge for clinical staffs to overcome. The typical or specific case report may contribute to the standardized treatment programs and individualization with respect to the therapy of TRD. This case report is concerned with three hospitalized TRD patients as well as the diagnosis and treating processes in The First Affiliated Hospital of Zhejiang University and a minor review of the advancement up to date about the drug therapy of TRD is given.
引文
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