LES SYMPTOMES RESIDUELS DANS LA DEPRESSION
Journal: International Journal of Advanced Research (Vol.9, No. 03)Publication Date: 2021-03-17
Authors : S. Belbachir M. Elkadiri A. Ouanass; Siham Belbachir;
Page : 155-158
Keywords : ;
Abstract
Si la remission de la depression est lobjectif therapeutique principal, la frequence de remissions partielles reste elevee. Les symptomes les plus frequemment rapportes sont propres a la depression notamment lanxiete et lirritabilite, lhumeur depressive, lasthenie et les troubles du sommeil. Les etudes sur la depression avec symptomes residuels restent peu nombreuses et concernent surtout des populations de patients hospitalises ou a forme sevère de depression. La presence de symptomes residuels est associee a un taux de rechutes depressives plus eleve, jusqua 5 fois plus rapidement que chez les sujets en remission sans symptomes residuels, a une augmentation du taux de suicides, une consommation de soins importante et un handicap social prononce. Les symptomes residuels constitueraient un marqueur clinique pour le pronostic surtout en termes de rechute et chronicite et devraient faire lobjet de strategies therapeutiques specifiques. Il nous a paru pertinent de selectionner une population de patients deprimes suivi en consultation psychiatrique. Notre objectif principal etait danalyser la frequence des symptomes residuels après 8 a 12 semaines de traitement antidepresseur et detudier les caracteristiques cliniques et sociodemographiques de ces sujets. La persistance de symptomes residuels après traitement dun episode depressif majeur est retrouvee dans environ un tiers des cas. Il existe des liens etroits entre persistance de symptomes residuels a lissue dun episode depressif majeur, et risque de nouvel episode depressif, comme le soulignent a la fois les recommandations de groupes dexperts et de societes savantes, et les etudes cliniques menees sur ce sujet. Parmi les facteurs de risque de survenue dun episode ulterieur, le poids de la persistance de symptomes residuels pourrait même être superieur a celui du nombre depisodes depressifs anterieurs. Les propositions therapeutiques, en cas de symptomes residuels, sappuyant sur des outils pharmacologiques ou psychotherapiques, sont essentiellement de deux types : potentialisation non specifique du traitement antidepresseur anterieur et adjonction de traitement ciblant specifiquement les symptomes residuels retrouves chez chaque patient jusqua leur disparition. If the remission of depression is the main therapeutic objective, the frequency of partial remissions is high. The most commonly reported symptoms are specific to depression: anxiety and irritability, depressed mood, asthenia, and sleep disturbances. Studies on depression with residual symptoms are few and concern hospitalized patients or patients with severe forms of depression. The presence of residual symptoms is associated with a higher rate of depressive relapse, up to 5 times faster than in subjects in remission without residual symptoms, an increase in the suicide rate and social handicap pronounced. The residual symptoms would constitute a clinical marker for the prognosis especially in terms of relapse and chronicity and should be the subject of specific therapeutic strategies.It seemed appropriate to select a population of depressed patients followed by psychiatric consultation. Our main objective was to analyze the frequency of residual symptoms after 8 to 12 weeks of antidepressant treatment and to study the clinical and socio-demographic characteristics of these subjects. The persistence of residual symptoms after treatment of a major depressive episode is found in about a third of cases. There are close links between the persistence of residual symptoms after a major depressive episode, and the risk of a new depressive episode, as highlighted both by the recommendations of expert groups and learned societies, and clinical studies.
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