Abstract:
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.
摘要:
抑郁症是亨廷顿病(HD)患者中常见的精神疾病。HD中的抑郁症和重度抑郁症似乎具有不同的病理生理机制。尽管有独特的病理生理学,HD中抑郁症的治疗是基于一般人群中重度抑郁症的治疗数据。本系统审查的目的是对现有证据进行全面评估。遵循系统评价和荟萃分析指南的首选报告项目。通过搜索MEDLINE,确定了HD抑郁症治疗的研究,Embase,和PsycInfo。最初的搜索产生了2771条记录,最终包括了41个。有19例病例报告,七个案例系列,三项横断面研究,一项定性研究,九项非随机研究,和纳入研究中的两项随机试验。最常见的评估工具是医院焦虑和抑郁量表(N=8),贝克抑郁量表(N=6),和汉密尔顿抑郁量表(N=6)。只有59%的纳入研究使用评分系统评估抑郁症状。治疗抑郁症的药物选择包括抗抑郁药和抗精神病药。非药理学方法是多学科康复,心理治疗,和神经刺激。关于HD治疗抑郁症的证据有限,本文献主要包括病例报告和病例系列。本系统综述强调了知识差距和对HD特定研究的迫切需要,以确定HD抑郁症治疗方法的疗效。