度洛西汀治疗人格解体-现实解体障碍的探索性研究

doi:10.3969/j.issn.1006-7795.2023.04.012

首都医科大学学报 ›› 2023, Vol. 44 ›› Issue (4): 578-582.doi: 10.3969/j.issn.1006-7795.2023.04.012

• 精神疾病中西医结合治疗 • 上一篇下一篇

度洛西汀治疗人格解体-现实解体障碍的探索性研究

郑思思^1,2，宋明康^1,2，宋楠^1,2，朱虹^1,2，贾竑晓^1,2*

1.首都医科大学附属北京安定医院国家精神心理疾病临床医学研究中心精神疾病诊断与治疗北京市重点实验室，北京 100088；2. 首都医科大学人脑保护高精尖创新中心，北京 100069

收稿日期:2023-04-02 出版日期:2023-08-21 发布日期:2023-07-26
通讯作者: 贾竑晓 E-mail:jhxlj@ccmu.edu.cn
基金资助:
北京市医院管理中心临床医学发展专项( ZYLX202129)，北京市医院管理中心青年人才培养“青苗”计划项目(QML20191901)，北京市医院管理中心“登峰”人才培养计划项目(DFL20191901)

A preliminary study on the therapeutic efficacy of Duloxetine in the treatment of depersonalization-derealization disorder

Zheng Sisi^1,2, Song Mingkang^1,2, Song Nan^1,2, Zhu Hong^1,2, Jia Hongxiao^1,2*

1．The National Clinical Research Center for Mental Disorders ＆ Beijing Key Laboratory of Mental Disorders，Beijing Anding Hospital， Capital Medical University，Beijing 100088，China; 2．Advanced Innovation Center for Human Brain Protection，Capital Medical University，Beijing 100069，China

Received:2023-04-02 Online:2023-08-21 Published:2023-07-26
Supported by:
This study was supported by the Beijing Hospitals Authority Clinical Medicine Development of Special Funding ( ZYLX202129), Beijing Hospitals Authority Youth Program (QML20191901)， and Beijing Hospitals Authority’s Ascent Plan (DFL20191901).

摘要/Abstract

摘要： 目的探索度洛西汀治疗人格解体-现实解体障碍（depersonalization-derealization disorder, DPD）的效果及影响因素。方法收集2020年1月至2022年12月就诊于首都医科大学附属北京安定医院度洛西汀治疗DPD的患者资料，采用生存分析方法进行疗效及影响因素分析。结果本研究共纳入51名患者，64.7%的患者治疗有效，中位有效时间为118（87, 643）d，且对情感麻木症状具有改善较快的趋势。受教育年限为度洛西汀治疗的影响因素HR=0.81(0.70,0.95)，P=0.008。结论度洛西汀治疗DPD，尤其是以情感麻木为主诉的患者具有潜在获益，可为临床治疗DPD提供指导。

关键词: 度洛西汀, 人格解体-现实解体障碍, 疗效分析

Abstract: Objective To explore the efficacy and influencing factors of Duloxetine in the treatment of depersonalization-derealization disorder (DPD). Methods The data were collected from January 2020 to December 2022 for DPD patients treated with Duloxetine at Beijing Anding Hospital, Capital Medical University. Survival analysis was used to analyze treatment efficacy and influencing factors. Results A total of 51 patients were included in this study, and 64.7% of the patients showed treatment efficacy. The median effective time was 118 (87, 643) days, and there was a trend of rapid improvement in emotional numbness symptoms. Education level was identified as a significant influencing factor for duloxetine treatment, with HR=0.81 (0.70, 0.95), P=0.008. Conclusions Duloxetine treatment for DPD, particularly for the patients with emotional numbness as the main complaint, has potential benefits and provides guidance for clinical treatment of DPD.

Key words: Duloxetine, depersonalization-derealization disorder, therapeutic efficacy

中图分类号:

郑思思, 宋明康, 宋楠, 朱虹, 贾竑晓. 度洛西汀治疗人格解体-现实解体障碍的探索性研究[J]. 首都医科大学学报, 2023, 44(4): 578-582.

Zheng Sisi, Song Mingkang, Song Nan, Zhu Hong, Jia Hongxiao. A preliminary study on the therapeutic efficacy of Duloxetine in the treatment of depersonalization-derealization disorder[J]. Journal of Capital Medical University, 2023, 44(4): 578-582.

参考文献

［1］ Yang J Y, Millman L S M, David A S, et al. The prevalence of depersonalization-derealization disorder: a systematic review［J］. J Trauma Dissociation, 2023, 24(1): 8-41.
［2］ Michal M, Adler J, Wiltink J, et al. A case series of 223 patients with depersonalization-derealization syndrome［J］. BMC Psychiatry, 2016, 16: 203.
［3］ Simeon D, Knutelska M, Putnam F W, et al. Attention and memory in depersonalization-spectrum dissociative disorders: impact of selective-divided attentional condition, stimulus emotionality, and stress［J］. J Trauma Dissociation, 2023, 24(1): 42-62.
［4］徐蕊, 杨敬铭, 朱虹, 等. 人格解体障碍病人的自我面孔识别速度的研究［J］. 首都医科大学学报, 2017, 38(2): 192-196.
［5］贾竑晓, 徐蕊, 朱虹, 等. 人格解体障碍的自我认知损害的神经心理学研究进展［J］. 国际精神病学杂志, 2016, 43(1): 50-54.
［6］宋楠, 贾竑晓. 人格解体患者认知功能及与临床症状和社会功能的相关性［J］. 首都医科大学学报, 2020, 41(1): 59-63.
［7］ Hunter E C M, Charlton J, David A S. Depersonalisation and derealisation: assessment and management［J］. BMJ, 2017, 356: j745.
［8］ Sierra M. Depersonalization disorder: pharmacological approaches［J］. Expert Rev Neurother, 2008, 8(1): 19-26.
［9］ Simeon D, Guralnik O, Knutelska M, et al. Basal norepinephrine in depersonalization disorder［J］. Psychiatry Res, 2003, 121(1): 93-97.
［10］ American Psychiatric Association, American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5［M］. 5th ed. Washington, D.C.: American Psychiatric Association, 2013:302.
［11］ Jay E L, Sierra M, Van Den Eynde F, et al. Testing a neurobiological model of depersonalization disorder using repetitive transcranial magnetic stimulation［J］. Brain Stimul, 2014, 7(2): 252-259.
［12］ Simeon D, Kozin D S, Segal K, et al. De-constructing depersonalization: further evidence for symptom clusters［J］. Psychiatry Res, 2008, 157(1/3): 303-306.
［13］ Segal S K, Cahill L. Endogenous noradrenergic activation and memory for emotional material in men and women［J］. Psychoneuroendocrinology, 2009, 34(9): 1263-1271.
［14］ Montagrin A, Sander D. Emotional memory: from affective relevance to arousal［J］. Behav Brain Sci, 2016, 39: e216.
［15］ Segal S K, Stark S M, Kattan D, et al. Norepinephrine-mediated emotional arousal facilitates subsequent pattern separation［J］. Neurobiol Learn Mem, 2012, 97(4): 465-469.

[1]	郭宇, 陈伟观, 周三连, 汤莉巧, 孙王妍, 张冬梅, 卢红建. 急性缺血性脑卒中患者血清糖蛋白非转移性黑色素瘤蛋白B蛋白浓度与疾病严重度及预后的相关性分析[J]. 首都医科大学学报, 2025, 46(4): 702-709.
[2]	蒋忱冠, 刘演, 杨舟, 李秉心, 张建国, 石林. 丘脑底核脑深部电刺激对帕金森患者非运动症状长期疗效研究进展[J]. 首都医科大学学报, 2025, 46(4): 733-741.
[3]	霍碧岫, 贾竑晓, 宁艳哲, 郑思思. 冠状动脉粥样硬化性心脏病心气虚证患者自上而下和自下而上注意模式的异常[J]. 首都医科大学学报, 2025, 46(3): 455-462.
[4]	冼淑连, 贾竑晓, 李雪, 王娣, 宋明康.尹冬青, 姜海荣. 抗精神病药物所致的代谢综合征中医证型分布规律研究[J]. 首都医科大学学报, 2025, 46(3): 463-470.
[5]	李雪, 贾竑晓, 朱虹, 冯正田, 郑思思, 吴子遥, 段宇. 基于网络分析方法的广泛性焦虑障碍中医核心证素研究[J]. 首都医科大学学报, 2025, 46(3): 471-478.
[6]	尹冬青, 贾竑晓, 李雪, 郑思思, 宁艳哲. 清热解郁方治疗双相抑郁火热内郁证的随机双盲对照研究[J]. 首都医科大学学报, 2025, 46(3): 479-486.
[7]	李玥, 陈俊逾, 常春雷, 张静. 基于NLRP3/IL-18/NF-κB通路探讨化痰安神方改善神经元细胞凋亡的作用机制[J]. 首都医科大学学报, 2025, 46(3): 487-495.
[8]	霍碧岫, 贾竑晓, 宁艳哲. 冠状动脉动脉粥样硬化性心脏病患者认知功能下降的研究进展 [J]. 首都医科大学学报, 2025, 46(3): 496-502.
[9]	任倩薇, 周思怡, 金鑫悦, 郭馥祯, 管仲军. 城市社区居民卒中相关影响因素分析：基于倾向评分匹配的病例对照研究[J]. 首都医科大学学报, 2025, 46(3): 520-526.
[10]	王拥军, 刘涛, 刘子阳, 熊云云, 荆京, 谢雪微, 李子孝. 人工智能在脑血管病领域中的应用[J]. 首都医科大学学报, 2025, 46(2): 177-183.
[11]	齐涵, 董程程, 刘瑞, 朱雪泉, 蔺煦舟, 秦妍舒, 于子博, 王海宁, 李蕾, 冯媛, 张玲, 闫芳. 抑郁症患者体质量指数和代谢综合征转移规律研究[J]. 首都医科大学学报, 2025, 46(2): 202-209.
[12]	李清, 赵潇雯, 任敬, 余淼, 崔瀚方, 丁芳园, 刘昊, 李琼, 王凡, 李青, 陈希妍, 路承彪, 李少敏, 赵建华. 血清缺氧诱导因子-1α浓度与脑微出血及认知功能障碍的相关性[J]. 首都医科大学学报, 2025, 46(2): 216-227.
[13]	景娇, 张思瑶, 刘艳伶, 王芬, 肖伟, 王振中. 银杏二萜内酯葡胺注射液对有无大动脉粥样硬化型急性缺血性脑卒中患者的有效性研究[J]. 首都医科大学学报, 2025, 46(2): 228-233.
[14]	字晓慧, 夏雪, 李静, 张晓丽, 周全, 王安心, 王伊龙. 抗血小板治疗在静脉溶栓卒中患者中的应用研究进展[J]. 首都医科大学学报, 2025, 46(2): 234-242.
[15]	伍琳, 孙君昭, 韩铖琛, 聂幸幸, 田宇红, 皮红英. 远端缺血适应对自发性脑出血患者的应用效果观察 [J]. 首都医科大学学报, 2025, 46(2): 356-362.

度洛西汀治疗人格解体-现实解体障碍的探索性研究

A preliminary study on the therapeutic efficacy of Duloxetine in the treatment of depersonalization-derealization disorder

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价