Shayan Abdollah Zadegan, Frank Ramirez, Kirthan S Reddy, Onur Sahin, Natalia Pessoa Rocha, Antonio L Teixeira, Erin Furr Stimming
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引用次数: 0
摘要
抑郁症是亨廷顿氏病(HD)患者中常见的一种精神障碍。HD抑郁症和重度抑郁障碍似乎具有不同的病理生理机制。尽管病理生理学独特,但治疗 HD 抑郁症的方法却是基于治疗普通人群重度抑郁障碍的数据。本系统综述旨在对现有证据进行全面评估。研究遵循了《系统综述和元分析首选报告项目》指南。通过检索 MEDLINE、Embase 和 PsycInfo,确定了有关治疗 HD 抑郁症的研究。初步搜索共获得 2,771 条记录,其中 41 条最终被纳入。在纳入的研究中,有 19 个病例报告、7 个系列病例、3 个横断面研究、1 个定性研究、9 个非随机研究和 2 个随机试验。最常见的评估工具是医院焦虑抑郁量表(8 项)、贝克抑郁量表(6 项)和汉密尔顿抑郁评定量表(6 项)。在纳入的研究中,只有 59% 的研究采用评分系统评估抑郁症状。治疗抑郁症的药物包括抗抑郁药和抗精神病药。非药物治疗方法包括多学科康复、心理治疗和神经刺激。有关治疗 HD 抑郁症的证据有限,而且这些文献主要由病例报告和系列病例组成。这篇系统性综述强调了知识差距以及对 HD 专项研究的迫切需要,以确定治疗 HD 抑郁症方法的疗效。
Treatment of Depression in Huntington's Disease: A Systematic Review.
Depression is a common psychiatric disorder among individuals with Huntington's disease (HD). Depression in HD and major depressive disorder appear to have different pathophysiological mechanisms. Despite the unique pathophysiology, the treatment of depression in HD is based on data from the treatment of major depressive disorder in the general population. The objective of this systematic review was to conduct a comprehensive evaluation of the available evidence. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Studies on the treatment of depression in HD were identified by searching MEDLINE, Embase, and PsycInfo. The initial search yielded 2,771 records, 41 of which were ultimately included. There were 19 case reports, seven case series, three cross-sectional studies, one qualitative study, nine nonrandomized studies, and two randomized trials among the included studies. The most common assessment tools were the Hospital Anxiety and Depression Scale (N=8), the Beck Depression Inventory (N=6), and the Hamilton Depression Rating Scale (N=6). Only 59% of the included studies assessed depressive symptoms with a scoring system. The pharmacological options for the treatment of depression included antidepressants and antipsychotics. Nonpharmacological approaches were multidisciplinary rehabilitation, psychotherapy, and neurostimulation. Limited evidence on the treatment of depression in HD was available, and this literature consisted mainly of case reports and case series. This systematic review highlights the knowledge gap and the pressing need for HD-specific research to determine the efficacy of treatment approaches for depression in HD.
期刊介绍:
As the official Journal of the American Neuropsychiatric Association, the premier North American organization of clinicians, scientists, and educators specializing in behavioral neurology & neuropsychiatry, neuropsychology, and the clinical neurosciences, the Journal of Neuropsychiatry and Clinical Neurosciences (JNCN) aims to publish works that advance the science of brain-behavior relationships, the care of persons and families affected by neurodevelopmental, acquired neurological, and neurodegenerative conditions, and education and training in behavioral neurology & neuropsychiatry. JNCN publishes peer-reviewed articles on the cognitive, emotional, and behavioral manifestations of neurological conditions, the structural and functional neuroanatomy of idiopathic psychiatric disorders, and the clinical and educational applications and public health implications of scientific advances in these areas. The Journal features systematic reviews and meta-analyses, narrative reviews, original research articles, scholarly considerations of treatment and educational challenges in behavioral neurology & neuropsychiatry, analyses and commentaries on advances and emerging trends in the field, international perspectives on neuropsychiatry, opinions and introspections, case reports that inform on the structural and functional bases of neuropsychiatric conditions, and classic pieces from the field’s rich history.