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Abstract：
UNASSIGNED: Treatment-resistant depression (TRD) and treatment-resistant bipolar depression (TRBD) poses a significant clinical and societal burden, relying on different operational definitions and treatment approaches. The detection of clinical predictors of resistance is elusive, soliciting clinical subtyping of the depressive episodes, which represents the goal of the present study.
UNASSIGNED: A hundred and thirty-one depressed outpatients underwent psychopathological evaluation using major rating tools, including the Hamilton Rating Scale for Depression, which served for subsequent principal component analysis, followed-up by cluster analysis, with the ultimate goal to fetch different clinical subtypes of depression.
UNASSIGNED: The cluster analysis identified two clinically interpretable, yet distinctive, groups among 53 bipolar (resistant cases = 15, or 28.3%) and 78 unipolar (resistant cases = 20, or 25.6%) patients. Among the MDD patients, cluster \"1\" included the following components: \"Psychic symptoms, depressed mood, suicide, guilty, insomnia\" and \"genitourinary, gastrointestinal, weight loss, insight\". Altogether, with broadly defined \"mixed features,\" this latter cluster correctly predicted treatment outcome in 80.8% cases of MDD. The same \"broadly-defined\" mixed features of depression (namely, the standard Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition-DSM-5-specifier plus increased energy, psychomotor activity, irritability) correctly classified 71.7% of BD cases, either as TRBD or not.
UNASSIGNED: Small sample size and high rate of comorbidity.
UNASSIGNED: Although relying on different operational criteria and treatment history, TRD and TRBD seem to be consistently predicted by broadly defined mixed features among different clinical subtypes of depression, either unipolar or bipolar cases. If replicated by upcoming studies to encompass also biological and neuropsychological measures, the present study may aid in precision medicine and informed pharmacotherapy.
UNASSIGNED: A hundred and thirty-one depressed outpatients underwent psychopathological evaluation using major rating tools, including the Hamilton Rating Scale for Depression, which served for subsequent principal component analysis, followed-up by cluster analysis, with the ultimate goal to fetch different clinical subtypes of depression.
UNASSIGNED: The cluster analysis identified two clinically interpretable, yet distinctive, groups among 53 bipolar (resistant cases = 15, or 28.3%) and 78 unipolar (resistant cases = 20, or 25.6%) patients. Among the MDD patients, cluster \"1\" included the following components: \"Psychic symptoms, depressed mood, suicide, guilty, insomnia\" and \"genitourinary, gastrointestinal, weight loss, insight\". Altogether, with broadly defined \"mixed features,\" this latter cluster correctly predicted treatment outcome in 80.8% cases of MDD. The same \"broadly-defined\" mixed features of depression (namely, the standard Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition-DSM-5-specifier plus increased energy, psychomotor activity, irritability) correctly classified 71.7% of BD cases, either as TRBD or not.
UNASSIGNED: Small sample size and high rate of comorbidity.
UNASSIGNED: Although relying on different operational criteria and treatment history, TRD and TRBD seem to be consistently predicted by broadly defined mixed features among different clinical subtypes of depression, either unipolar or bipolar cases. If replicated by upcoming studies to encompass also biological and neuropsychological measures, the present study may aid in precision medicine and informed pharmacotherapy.
摘要：
■难治性抑郁症（TRD）和难治性双相抑郁症（TRBD）构成了重大的临床和社会负担，依靠不同的操作定义和治疗方法。耐药性的临床预测因子的检测是难以捉摸的，寻求抑郁发作的临床亚型，这代表了本研究的目标。
■使用主要评级工具对131名抑郁症门诊患者进行了心理病理学评估，包括汉密尔顿抑郁量表，用于后续的主成分分析，后续进行聚类分析，最终目标是获取不同的抑郁症临床亚型。
■聚类分析确定了两个临床可解释的，然而独特的，在53个双极（耐药病例=15，或28.3％）和78个单极（耐药病例=20，或25.6％）患者中。在MDD患者中，群集\"1\"包括以下组件：\"精神症状，情绪低落,自杀,有罪,失眠“和”泌尿生殖系统，胃肠,减肥,洞察力\“。总之,具有广泛定义的“混合功能”，“后一组正确预测了80.8%MDD病例的治疗结果。抑郁症的相同“广义”混合特征(即，标准的精神疾病诊断和统计手册，第五版-DSM-5-说明符加上增加的能量，精神运动活动，烦躁)正确分类了71.7%的BD病例，作为TRBD或不。
■样本量小，合并率高。
■尽管依赖于不同的操作标准和治疗历史，TRD和TRBD似乎是由不同临床亚型抑郁症之间广泛定义的混合特征一致预测的。单极或双极病例。如果被即将进行的研究所复制，包括生物学和神经心理学措施，本研究可能有助于精准医学和知情药物治疗。
■使用主要评级工具对131名抑郁症门诊患者进行了心理病理学评估，包括汉密尔顿抑郁量表，用于后续的主成分分析，后续进行聚类分析，最终目标是获取不同的抑郁症临床亚型。
■聚类分析确定了两个临床可解释的，然而独特的，在53个双极（耐药病例=15，或28.3％）和78个单极（耐药病例=20，或25.6％）患者中。在MDD患者中，群集\"1\"包括以下组件：\"精神症状，情绪低落,自杀,有罪,失眠“和”泌尿生殖系统，胃肠,减肥,洞察力\“。总之,具有广泛定义的“混合功能”，“后一组正确预测了80.8%MDD病例的治疗结果。抑郁症的相同“广义”混合特征(即，标准的精神疾病诊断和统计手册，第五版-DSM-5-说明符加上增加的能量，精神运动活动，烦躁)正确分类了71.7%的BD病例，作为TRBD或不。
■样本量小，合并率高。
■尽管依赖于不同的操作标准和治疗历史，TRD和TRBD似乎是由不同临床亚型抑郁症之间广泛定义的混合特征一致预测的。单极或双极病例。如果被即将进行的研究所复制，包括生物学和神经心理学措施，本研究可能有助于精准医学和知情药物治疗。
