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新冠病毒感染后(post-COVID-19)患者中,伴发焦虑症状对伏硫西汀改善抑郁症状的影响:一项二次分析。

Impact of vortioxetine on depressive symptoms moderated by symptoms of anxiety in persons with post-COVID-19 condition: A secondary analysis.

机构信息

Brain and Cognition Discovery Foundation, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.

Brain and Cognition Discovery Foundation, Toronto, Ontario, Canada; Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.

出版信息

Psychiatry Res. 2024 Sep;339:116068. doi: 10.1016/j.psychres.2024.116068. Epub 2024 Jun 28.

Abstract

OBJECTIVE

Recovery from a COVID-19 infection can lead to post-COVID-19 condition (PCC), which causes a multitude of debilitating symptoms that negatively affect an individual's health-related quality of life, including depressive and anxiety symptoms. We aim to examine the mediatory effects of anxiety on depressive symptoms in persons with PCC receiving vortioxetine.

METHODS

We performed a post-hoc analysis of a randomized, double-blinded, placebo-controlled clinical trial investigating vortioxetine treatment on cognitive functioning in persons with PCC. Anxiety and depressive symptoms were measured by the 7-Item Generalized Anxiety Disorder (GAD-7) Scale and the 16-Item Quick Inventory of Depressive Symptomatology (QIDS-SR-16), respectively.

RESULTS

Based on data of 147 participants, GAD-7 scores were significantly positively associated with QIDS-SR-16 scores (β=0.038, 95 % CI [0.029,0.047], p < 0.001). After adjusting for covariates, a significant group (χ=176.786, p < 0.001), time (χ=8.914, p = 0.003), and treatment x time x GAD-7 score interaction (χ=236.483, p < 0.001) effect was observed. Vortioxetine-treated participants had a significant difference in overall change in depressive symptoms (mean difference=-3.15, SEM=0.642, 95 % CI [-4.40,-1.89], p < 0.001).

CONCLUSION

Anxiety symptoms were significantly associated with depressive symptoms in persons with PCC. Antidepressant efficacy on ameliorating depressive symptoms is dependent on improving anxiety symptoms, underscoring significant implications in improving treatment efficacy and patient quality of life.

摘要

目的

从 COVID-19 感染中康复后可能会导致新冠后状况(PCC),这会导致多种使人虚弱的症状,对个人的健康相关生活质量产生负面影响,包括抑郁和焦虑症状。我们旨在研究在接受文拉法辛治疗的 PCC 患者中,焦虑对抑郁症状的中介作用。

方法

我们对一项随机、双盲、安慰剂对照的临床试验进行了事后分析,该试验研究了文拉法辛对 PCC 患者认知功能的治疗作用。焦虑和抑郁症状分别通过 7 项广泛性焦虑障碍(GAD-7)量表和 16 项快速抑郁症状清单(QIDS-SR-16)进行测量。

结果

基于 147 名参与者的数据,GAD-7 评分与 QIDS-SR-16 评分呈显著正相关(β=0.038,95 % CI [0.029,0.047],p < 0.001)。在调整协变量后,观察到显著的组间(χ=176.786,p < 0.001)、时间(χ=8.914,p = 0.003)和治疗 x 时间 x GAD-7 评分交互作用(χ=236.483,p < 0.001)效应。文拉法辛治疗组的抑郁症状总体变化有显著差异(平均差异=-3.15,SEM=0.642,95 % CI [-4.40,-1.89],p < 0.001)。

结论

在 PCC 患者中,焦虑症状与抑郁症状显著相关。抗抑郁药改善抑郁症状的疗效取决于改善焦虑症状,这突显了改善治疗效果和患者生活质量的重要意义。

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