| Objective:Cognitive impairment has become the clinical feature and core diagnostic criteria of depressive disorder,and is the main determinant of functional recovery in patients with unipolar depressive disorder.Escitalopram and sertraline can effectively improve the emotional symptoms and cognitive function of patients with depressive disorder,and are widely used in clinic,which can promote the recovery of social function of patients and further improve the quality of life of patients.This article concentrates on comparing the therapeutic effects of escitalopram and sertraline on the emotional symptoms and cognitive function of patients with first-episode unipolar depression.By comparing the HAMD score,each factor score and PDQ-5 score,and combining with the clinical efficacy,whether there are differences between the two drugs in improving emotional symptoms and cognitive function is compared,so as to further guide clinical practice.Method : A total of 165 patients with first episode unipolar depressive disorder from March 1,2019 to September 30,2019 in the inpatient ward of Shandong Mental Health Center.Among them,5patients fell off,and 160 patients actually.They were collected and randomly divided into escitalopram treatment group(group A)and sertraline treatment group(group B)with 80 patients in each group.Thegeneral demographic data such as age,course of disease,marital status,education level,sex composition ratio and so on were statistically analyzed and processed when the two groups were enrolled,and the difference was not statistically significant.Before treatment(baseline)and 1 week,2 weeks,4 weeks,6 weeks and 8 weeks after treatment,Hamilton Depression Scale(HAMD)was applied to assess the depressive symptoms of patients with first-episode depression,and the total score and scores of various factors were recorded.The clinical efficacy was evaluated by calculating the reduction rate of the total score.Cognitive function was assessed by Cognitive Deficiencies Questionnaire(PDQ-5),adverse drug reactions were assessed by Adverse Drug Reaction Scale(TESS),and the number of adverse drug reactions occurred in the two groups of patients was counted.Furthermore,the difference of adverse drug reactions caused by the two drugs was compared,thus improving the medication safety and tolerance of patients.Results:1.After 8 weeks of treatment,the cure rate of group A was 48.75%,and the effective rate was 86.25%.The cure rate of group B was 55%,and the effective rate was 87.5%.There was no significant difference in cure rate between group a and group b(?2=0.63,P>0.05).There was no significant difference in the effective rates between group A and group B(?2=0.06,P>0.05).The difference was not statistically significant,whichindicated that escitalopram and sertraline had no significant difference in the efficacy in improving the overall depressive symptoms of patients with depression.2.Comparing the scores of HAMD scale,the scores of HAMD scale in the two groups were significantly lower than before treatment(P<0.05)before treatment and 1 week,2 weeks,4 weeks,6 weeks and 8 weeks after treatment,and the difference was statistically significant.In comparison between groups,the total score of HAMD in group A was significantly lower than that in group B at 2 weeks after treatment(t=2.84,P<0.05),with statistically significant difference.After 1 week,4 weeks,6weeks and 8 weeks of treatment,there was no significant difference in the total score of HAMD between group A and group B(P>0.05).3.After 8 weeks of treatment,the scores of anxiety/somatization,cognitive disorder,block,sleep disorder and sense of despair in HAMD scores of the two groups were significantly lower than the baseline level(P<0.05),and the difference was statistically significant.In the block factor score,the score of group A was significantly lower than that of group B,with statistically significant difference(t=1.58,P<0.05).4.Comparing the scores of PDQ-5 between group A and group B,when they are at baseline,there is no significant difference in the scores of PDQ-5 between the two groups,and the difference is not statistically significant(P>0.05).At the 2nd week of treatment,the PDQ-5 score ofthe two groups was not significantly lower than that before treatment(P>0.05).After the 4th,6th and 8th weeks of treatment,the PDQ-5 scores of the two groups were significantly lower than those before treatment(P<0.05),and the difference was statistically significant.After 8 weeks of treatment,the scores of PDQ-5 scale in group A decreased more obviously than that in group B(t=2.74,P<0.01),the difference was statistically significant.5.The correlation between PDQ-5 score and HAMD total score and each factor score was compared between the two groups of patients.At the baseline and 2 weeks,4 weeks,6 weeks and 8 weeks of treatment,the PDQ-5 score of the two groups of patients was positively correlated with the cognitive impairment factor score in HAMD scale(P<0.05).The PDQ-5 score of the two groups of patients had no correlation with HAMD total score and other factor scores(P>0.05).6.During the whole clinical trial,12 cases(15%)had adverse reactions in group A and 14 cases(17.5%)in group B,with mild symptoms.There was no significant difference in adverse reactions between group A and group B by chi-square test(?2=5.18,P>0.05).There were no abnormal changes in blood routine,thyroid function and electrocardiogram before and after treatment in the two groups of patients.Two groups of patients each had a slight increase in transaminase,but did not exceed the normal range of 2 times.Conclusion : Patients with depressive disorder have cognitive impairment in different degrees when they are ill.Escitalopram and sertraline can obviously improve the overall depressive symptoms in the treatment of patients with first-episode unipolar depressive disorder,and the safety and tolerance are equivalent.Escitalopram has a faster curative effect.However,escitalopram is possibly better than sertraline in improving cognitive impairment and plays a positive role in the recovery of cognitive function and improvement of life quality. |
PDF Full Text Request