Patient-reported functioning in major depressive disorder

IsHak, Waguih William; James, David; Mirocha, James; Youssef, H. Ben; Tobia, Gabriel; Pi, Sarah; Collison, Katherine L.; Cohen, Robert M.

doi:10.1177/2040622316639769

Cited by 51 publications

(44 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Functional impairment is a key consequence of major depressive disorder (MDD). 1,2 Multiple domains of functioning are typically impaired in patients with MDD, particularly their ability to work and work productivity. [3][4][5][6][7] Depression has a considerable impact in the workplace worldwide.…”

Section: Introductionmentioning

confidence: 99%

“…[10][11][12][13][14] Systematic reviews have shown that improvement in mood symptoms is only modestly correlated with functional outcomes in MDD. 13,[15][16][17] Functional impairment can persist in patients with MDD even after remission of mood symptoms, 2,18,19 and residual functional impairment has been associated with an increased risk of relapse and recurrence of depression. 20,21 The clinical relevance of cognitive symptoms, including disturbances in attention, memory, processing speed, and executive functioning, and their role in work-related disability is well documented in MDD.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Long-term functioning outcomes are predicted by cognitive symptoms in working patients with major depressive disorder treated with vortioxetine: results from the AtWoRC study

Chokka

Bougie²,

Proulx³

et al. 2019

CNS Spectr.

View full text Add to dashboard Cite

ObjectiveAtWoRC (Assessment in Work productivity and the Relationship with Cognitive symptoms) was an interventional, open-label, Canadian study (NCT02332954) designed to assess the association between cognitive symptoms and workplace productivity in working patients with major depressive disorder (MDD) receiving vortioxetine.MethodsEligible patients with MDD received vortioxetine (10–20 mg/day) and were assessed over 52 weeks at visits emulating a real-life setting (n = 199). Partial correlation between changes in patient-reported cognitive symptoms (20-item Perceived Deficits Questionnaire–Depression; PDQ-D-20) and workplace productivity (Work Limitations Questionnaire; WLQ) was assessed at 12 and 52 weeks. Additional assessments included depression severity, cognitive performance, and patient-reported functioning. Structural equations model (SEM) analyses assessed causal relationships between changes in measures of cognition and functioning over time, adjusted for improvements in depressive symptoms.ResultsStatistically significant improvements in all outcomes from baseline to week 52 were seen in the overall population and both subgroups (first treatment and switch). Response and remission rates were 77% and 56%, respectively. Improvements in PDQ-D-20 and WLQ productivity loss scores at weeks 12 and 52 were significantly correlated. SEM analyses found patient-rated cognitive symptoms (PDQ-D-20) at weeks 12 and 26 were significantly predictive (p < 0.05) of patient-reported functioning (Sheehan Disability Scale) at the subsequent visit. Depression severity and objectively measured cognitive performance did not significantly predict functional outcomes at any timepoint.ConclusionThese results demonstrate the long-term benefits of vortioxetine treatment in working patients with MDD and emphasize the strong association between cognitive symptoms and functioning in a real-world setting.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Long-term functioning outcomes are predicted by cognitive symptoms in working patients with major depressive disorder treated with vortioxetine: results from the AtWoRC study

Chokka

Bougie²,

Proulx³

et al. 2019

CNS Spectr.

View full text Add to dashboard Cite

show abstract

“… 2 Compared with the general population, patients with MDD report substantial functional impairment. 3 – 8 In the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study, a large US study designed to assess the efficacy of sequential acute treatments for MDD, only 7% of patients reported within-normal functioning before initiation of antidepressant therapy. 8 The level of functional impairment associated with depression has been shown to equal or exceed that associated with other severe chronic general medical conditions, such as diabetes and congestive heart failure.…”

Section: Introductionmentioning

confidence: 99%

“… 14 – 16 Available data suggest that impaired functioning in patients with MDD can persist even after marked improvement in depressive symptoms. 8 , 14 , 17 – 19 This is of clinical significance because residual functional impairment has been associated with an increased risk of relapse and recurrence of depression. 20 , 21 From a patient’s perspective, return to usual levels of functioning may be as important a treatment outcome as resolution of depressive symptoms.…”

Section: Introductionmentioning

confidence: 99%

Functional impairment in patients with major depressive disorder: the 2-year PERFORM study

Hammer-Helmich

Haro

Jönsson

et al. 2018

NDT

View full text Add to dashboard Cite

BackgroundThe Prospective Epidemiological Research on Functioning Outcomes Related to Major depressive disorder (PERFORM) study describes the course of depressive symptoms, perceived cognitive symptoms, and functional impairment over 2 years in outpatients with major depressive disorder (MDD) and investigates the patient-related factors associated with functional impairment.MethodsThis was a 2-year observational study in 1,159 outpatients with MDD aged 18–65 years who were either initiating antidepressant monotherapy or undergoing their first switch of antidepressant. Functional impairment was assessed by the Sheehan Disability Scale and the Work Productivity and Activity Impairment questionnaire. Patients assessed depression severity using the nine-item Patient Health Questionnaire and severity of perceived cognitive symptoms using the five-item Perceived Deficit Questionnaire. To investigate which patient-related factors were associated with functional impairment, univariate analyses of variance were performed to identify relevant factors that were then included in multivariate analyses of covariance at baseline, month 2, months 6 and 12 combined, and months 18 and 24 combined.ResultsThe greatest improvement in depressive symptoms, perceived cognitive symptoms, and functional impairment was seen immediately (within 2 months) following initiation or switch of antidepressant therapy, followed by more gradual improvement and long-term stabilization. Improvement in perceived cognitive symptoms was less marked than improvement in depressive symptoms during the acute treatment phase. Functional impairment in patients with MDD was not only associated with severity of depressive symptoms but also independently associated with severity of perceived cognitive symptoms when adjusted for depression severity throughout the 2 years of follow-up.ConclusionThese findings highlight the burden of functional impairment in MDD and the importance of recognizing and managing cognitive symptoms in daily practice.

show abstract

“…Indeed, many remitted patients continue to experience ongoing deficits in functioning or quality of life. 11,12 Symptom-based scales will likely remain the standard for treatment outcome assessment in randomised controlled trials and clinical practice. However, it may be worthwhile to develop measures that assesses relevant domains other than symptom resolution.…”

mentioning

confidence: 99%

Patients’ and clinicians’ perspectives on relevant treatment outcomes in depression: qualitative study

et al. 2020

View full text Add to dashboard Cite

Background Although symptomatic remission is considered the optimal outcome in depression, this is not always achieved. Furthermore, symptom indicators do not fully capture patients’ and clinicians’ perspectives on remission. Broader indicators of (partial) remission from depression should be considered. Aims To investigate relevant outcomes of depression treatment in specialist care from patients’ and clinicians’ perspectives and to investigate whether these perspectives differ from each other. Method Three focus groups with 11 patients with depression and seven semi-structured interviews with clinicians were conducted exploring their perspectives on remission. All interviews were audio-recorded and transcribed verbatim. We analysed the transcripts thematically using the phenomenologist approach. Results Independently, both patients and clinicians perceived the following outcomes relevant: restoring social functioning and interpersonal relations, regaining quality of life and achieving personal goals. All clinicians emphasised symptom reduction and satisfaction with treatment as relevant outcomes, whereas the former was not an obvious theme in patients. Unlike clinicians, patients made a clear distinction between treatment outcomes in first versus recurrent/chronic depression. Conclusions Classically defined study outcomes based on symptom resolution only partly reflect issues considered important by patients and clinicians in specialist depression treatment. Incorporating patients’ and clinicians’ perspectives in the development of measurable end-points makes them more suitable for use in trials and subsequent translation to clinical practice. Furthermore, evaluating patients’ perspectives on treatment outcomes helps in the development of tailored interventions according to patients’ needs.

show abstract

Patient-reported functioning in major depressive disorder

Abstract: This study points to the importance of functional outcomes of MDD treatment as well as the need to develop personalized interventions to improve functioning in MDD.

Cited by 51 publications

References 50 publications

Long-term functioning outcomes are predicted by cognitive symptoms in working patients with major depressive disorder treated with vortioxetine: results from the AtWoRC study

Long-term functioning outcomes are predicted by cognitive symptoms in working patients with major depressive disorder treated with vortioxetine: results from the AtWoRC study

Functional impairment in patients with major depressive disorder: the 2-year PERFORM study

Patients’ and clinicians’ perspectives on relevant treatment outcomes in depression: qualitative study

Contact Info

Product

Resources

About