PDF(Pubmed)
Abstract：
UNASSIGNED: Anhedonia, a core diagnostic feature for major depressive disorder (MDD), is defined as the loss of pleasure and interest in daily activities. Its prevalence in MDD patients vary from 35 to 70%. Anhedonia in MDD negatively impacts functioning and is associated with treatment resistance and poorer prognosis for various clinical outcomes. Owing to its complexity, there remains considerable heterogeneity in the conceptualization, diagnosis and clinical management of anhedonia in MDD.
UNASSIGNED: This modified Delphi panel was conducted to elicit expert opinion and establish consensus on concepts relating to clinical features, diagnosis and treatment of MDD with anhedonia (MDDwA) amongst psychiatrists in the Asia-Pacific region. Seven themes were covered. A three-stage process was adopted for consensus generation (two online survey rounds, followed by a moderated consensus meeting). Statements were developed based on a literature review and input from a steering committee of six regional experts. The panel included 12 psychiatrists practicing in Australia, China, Hong Kong, Japan, South Korea and Taiwan with ≥5 years of specialist clinical experience, including assessment or management of patients with MDDwA.
UNASSIGNED: Overall, consensus was achieved (median ≥8) on 89/103 statements (86%). About half of the statements (55/103, 53%) achieved consensus in Round 1, and 29/36 modified statements achieved consensus in Round 2. At the moderated consensus meeting, five modified statements were discussed by the steering committee and consensus was achieved on all statements (5/5). The findings highlighted a lack of clear and practical methods in clinical practice for assessing anhedonia in MDD patients and limited physician awareness of anhedonia in Asia-Pacific.
UNASSIGNED: Insights from this Delphi consensus provide a reference point for psychiatrists in Asia-Pacific to optimize their strategies for personalized diagnosis and management of patients with MDDwA. Identification of distinct and clinically relevant subtypes in MDD may be valuable for guiding personalized diagnosis and management approaches, including type-specific therapies.
UNASSIGNED: This modified Delphi panel was conducted to elicit expert opinion and establish consensus on concepts relating to clinical features, diagnosis and treatment of MDD with anhedonia (MDDwA) amongst psychiatrists in the Asia-Pacific region. Seven themes were covered. A three-stage process was adopted for consensus generation (two online survey rounds, followed by a moderated consensus meeting). Statements were developed based on a literature review and input from a steering committee of six regional experts. The panel included 12 psychiatrists practicing in Australia, China, Hong Kong, Japan, South Korea and Taiwan with ≥5 years of specialist clinical experience, including assessment or management of patients with MDDwA.
UNASSIGNED: Overall, consensus was achieved (median ≥8) on 89/103 statements (86%). About half of the statements (55/103, 53%) achieved consensus in Round 1, and 29/36 modified statements achieved consensus in Round 2. At the moderated consensus meeting, five modified statements were discussed by the steering committee and consensus was achieved on all statements (5/5). The findings highlighted a lack of clear and practical methods in clinical practice for assessing anhedonia in MDD patients and limited physician awareness of anhedonia in Asia-Pacific.
UNASSIGNED: Insights from this Delphi consensus provide a reference point for psychiatrists in Asia-Pacific to optimize their strategies for personalized diagnosis and management of patients with MDDwA. Identification of distinct and clinically relevant subtypes in MDD may be valuable for guiding personalized diagnosis and management approaches, including type-specific therapies.
摘要：
■Anhedonia,重度抑郁症（MDD）的核心诊断特征，被定义为对日常活动失去乐趣和兴趣。其在MDD患者中的患病率从35%到70%不等。MDD中的快感缺失会对功能产生负面影响，并与治疗耐药性和各种临床结果的不良预后有关。由于其复杂性,概念化仍然存在相当大的异质性，MDD快感缺乏的诊断和临床处理。
■进行此改良的Delphi小组，以征求专家意见并就与临床特征相关的概念达成共识。亚太地区精神科医生对MDD伴快感缺失症(MDDwA)的诊断和治疗.涵盖了七个主题。共识生成采用了三个阶段的过程(两轮在线调查，随后举行了一次温和的共识会议)。声明是根据文献审查和由六名区域专家组成的指导委员会的投入制定的。该小组包括在澳大利亚执业的12名精神科医生，中国,香港,Japan,韩国和台湾有5年以上专科临床经验，包括MDDwA患者的评估或管理。
■总的来说，89/103(86%)的陈述达成共识(中位数≥8).大约一半的声明（55/103，53％）在第一轮中达成共识，而29/36的修改声明在第二轮中达成共识。在主持的协商一致会议上，指导委员会讨论了五项修改后的声明，并就所有声明达成了共识(5/5)。研究结果强调了在临床实践中缺乏明确和实用的方法来评估MDD患者的快感缺乏症，并且亚太地区医生对快感缺乏症的认识有限。
■来自此Delphi共识的见解为亚太地区的精神科医生提供了一个参考点，以优化其个性化诊断和管理MDDwA患者的策略。在MDD中识别不同的和临床相关的亚型对于指导个性化诊断和管理方法可能是有价值的。包括特定类型的疗法。
■进行此改良的Delphi小组，以征求专家意见并就与临床特征相关的概念达成共识。亚太地区精神科医生对MDD伴快感缺失症(MDDwA)的诊断和治疗.涵盖了七个主题。共识生成采用了三个阶段的过程(两轮在线调查，随后举行了一次温和的共识会议)。声明是根据文献审查和由六名区域专家组成的指导委员会的投入制定的。该小组包括在澳大利亚执业的12名精神科医生，中国,香港,Japan,韩国和台湾有5年以上专科临床经验，包括MDDwA患者的评估或管理。
■总的来说，89/103(86%)的陈述达成共识(中位数≥8).大约一半的声明（55/103，53％）在第一轮中达成共识，而29/36的修改声明在第二轮中达成共识。在主持的协商一致会议上，指导委员会讨论了五项修改后的声明，并就所有声明达成了共识(5/5)。研究结果强调了在临床实践中缺乏明确和实用的方法来评估MDD患者的快感缺乏症，并且亚太地区医生对快感缺乏症的认识有限。
■来自此Delphi共识的见解为亚太地区的精神科医生提供了一个参考点，以优化其个性化诊断和管理MDDwA患者的策略。在MDD中识别不同的和临床相关的亚型对于指导个性化诊断和管理方法可能是有价值的。包括特定类型的疗法。
