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Subgrouping time-dependent prescribing patterns of first-onset major depressive episodes by psychotropics dissection

引用

World Journal of Psychiatry 2021年第11期11卷 1116-1128页

作者： Hsi-Chung Chen Hui-Hsuan Hsu Mong-Liang Lu Ming-Chyi Huang Chun-Hsin Chen Tzu-Hua Wu Wei-Chung Mao chuhsing k hsiao Po-Hsiu kuo Department of Psychiatry&Center of Sleep Disorders National Taiwan University HospitalTaipei 100Taiwan Center of Statistical Consultation and Research National Taiwan University HospitalTaipei 100Taiwan Department of Psychiatry Wan-Fang Hospital&School of MedicineCollege of MedicineTaipei Medical UniversityTaipei 100Taiwan Department of Psychiatry Taipei City HospitalSongde BranchTaipei 100Taiwan Department of Clinical Pharmacy School of PharmacyCollege of PharmacyTaipei Medical UniversityTaipei 110Taiwan Department of Psychiatry Cheng-Hsin General HospitalTaipei 100Taiwan Graduate Institute of Epidemiology and Preventive Medicine College of Public HealthNational Taiwan UniversityTaipei 100Taiwan

BACkGROUND Subgrouping patients with major depressive disorder is a promising solution for the issue of ***,the link between available subtypes and distinct pathological mechanisms is weak and yields disappointing results in clinical *** To develop a novel approach for classification of patients with time-dependent prescription patterns at first onset in real-world *** Drug-naive patients experiencing their first major depressive episode(n=105)participated in this *** agents prescribed in the first 24 mo following disease onset were recorded monthly and categorized as antidepressants,augmentation agents,and *** cumulative doses of agents in each category were converted into relevant *** parameters were used to summarize the time-dependent prescription patterns for each psychotropic load:Stability,amount,frequency,and the time trend of monthly prescriptions.A k-means cluster analysis was used to derive subgroups of participants based on these input parameters of psychotropic agents across 24 *** validity of the resulting data-driven clusters was compared using relevant severity *** Four distinct clusters were derived from k-means analysis,which matches experts’consent:"Short-term antidepressants use","long-term antidepressants use","long-term antidepressants and sedatives use",and"long-term antidepressants,sedatives,and augmentation use".At the first 2 years of disease course,the four clusters differed on the number of antidepressants used at adequate dosage and duration,frequency of outpatient service use,and number of psychiatric *** the first 2 years following disease onset,depression severity was differed in the four *** Our findings suggested a new approach to optimize the subgrouping of patients with major depressive disorder,which may assist future etiological and treatment response studies.

关键词： First episode Depression Classification Psychopharmacology Depression treatment

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