Predictive value of oxidative stress markers for SSRIs treatment outcomes in patients with generalized anxiety disorder
Objective To explore the predictive value of oxidative stress markers for treatment outcomes of selective serotonin reuptake inhibitors(SSRIs)in patients with generalized anxiety disorder(GAD).Methods A total of 152 patients who met the Diagnostic and Statistical Manual of Mental Disorders-5(DSM-5)criteria for GAD at Huzhou Third Municipal Hospital from January 2022 to December 2022 were enrolled,among them 75 patients took oral escitalopram 10-20 mg/d and 77 patients took oral sertraline 50-200 mg/d for 8 weeks.The Hamilton Anxiety Scale(HAMA)was measured to evaluate anxiety symptoms before and after treatment.Based on HAMA scores ≤7 or＞7 after 8 weeks of SSRIs treatment,patients were categorized into a remission group(79 cases)or non-remission group(73 cases).The malondialdehyde(MDA),superoxide dismutase(SOD),high-density lipoprotein(HDL),glutathione peroxidase(GSH-Px),catalase,cortisol,nitric oxide(NO),and lipid peroxide(LPO)levels were measured and compare between the remission group and the non-remission group.The correlation of oxidative stress markers with HAMA score reduction was analyzed,and the factors affecting the treatment outcomes of SSRIs were determined with binary logistic regression.The performance of oxidative stress markers in predicting treatment outcomes of SSRIs for GAD patients was evaluated with ROC curve.Results The serum MDA and LPO levels in the remission group were lower than those in the non-remission group,while the SOD level was higher than that in the non-remission group(all P＜0.05).The levels of serum MDA and LPO in the remission group were negatively correlated and SOD was positively correlated with the HAMA score reduction rate after treatment(all P＜0.05).Binary logistic regression analysis revealed that the high serum MDA level and low SOD level in GAD patients were risk factors for SSRIs treatment remission(all P＜0.05).The areas under ROC curve(AUC)of MDA,SOD and their combination in predicting SSRIs treatment response were 0.758,0.661,and 0.779,respectively.The prediction value of the combination of MDA and SOD was higher than that of any single indicator.Conclusion The increased serum MDA levels and decreased SOD levels are risk factors for the remission of SSRIs treatment in GAD patients,and the combinations of these two biomarkers exhibits enhanced predictive value.
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