Factors associated with failure to achieve remission and with relapse after remission in patients with major depressive disorder in the PERFORM study
Por:
Saragoussi D, Touya M, Haro JM, Jönsson B, Knapp M, Botrel B, Florea I, Loft H and Rive B
Publicada:
1 ene 2017
Ahead of Print:
9 ago 2017
Resumen:
Background: The Prospective Epidemiological Research on Functioning Outcomes Related to Major Depressive Disorder (PERFORM) study has been initiated to better understand the course of a depressive episode and its impact on patient functioning. This analysis aimed to identify sociodemographic and clinical factors associated with failure to achieve remission at month 2 after initiating or switching antidepressant monotherapy and with subsequent relapse at month 6 for patients in remission at month 2.
Materials and methods: This was a 2-year observational cohort study in 1,159 outpatients aged 18-65 years with major depressive disorder initiating or undergoing the first switch of antidepressant monotherapy. Factors with P<0.20 in univariate logistic regression analyses were combined in a multiple logistic regression model to which backward variable selection was applied (ie, sequential removal of the least significant variable from the model and recomputation of the model until all remaining variables have P<0.05).
Results: Baseline factors significantly associated with lower odds of remission at month 2 were body-mass index >= 30 kg/m(2) (OR 0.51), depressive episode >8 weeks (OR 0.51), being in psychotherapy (OR 0.51), sexual dysfunction (OR 0.62), and severity of depression (OR 0.87). Factors significantly associated with relapse at month 6 were male sex (OR 2.47), being married or living as a couple (OR 2.73), residual patient-reported cognitive symptoms at 2 months (OR 1.12 per additional unit of Perceived Deficit Questionnaire-5 score) and residual depressive symptoms at 2 months (OR 1.27 per additional unit of Patient Health Questionnaire-9 score).
Conclusion: Different factors appear to be associated with failure to achieve remission in patients with major depressive disorder and with subsequent relapse in patients who do achieve remission. Patient-reported cognitive dysfunction is an easily measurable and treatable characteristic that may be associated with an increased likelihood of relapse at 6 months in patients who have achieved remission.
Filiaciones:
Saragoussi D:
Real-World Evidence and Epidemiology, Lundbeck SAS, Issy-les-Moulineaux, France
Touya M:
Health Economics and Outcomes Research, Lundbeck, Deerfield, IL, US
Haro JM:
Research and Teaching Unit, Parc Sanitari Sant Joan de Deu, CIBERSAM, University of Barcelona, Sant Boi de Llobregat, Barcelona, Spain
Jönsson B:
Department of Economics, Stockholm School of Economics, Stockholm, Sweden
Knapp M:
Department of Health Policy, London School of Economics and Political Science, London, UK
Botrel B:
Biostatistics, Inferential, Paris, France
Florea I:
Clinical Research Paediatrics, H. Lundbeck A/S, Valby, Denmark
Loft H:
Biometrics, H. Lundbeck A/S, Valby, Denmark
Rive B:
Global Analytics, Lundbeck SAS, Issy-les-Moulineaux, France
Green Published, gold, Green Accepted
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