Predictors of Treatment Response and Length of Stay for Inpatients with Major Depression

Cheng, I-Chih; Liao, Shih‐Cheng; Lee, Ming-Been; Tseng, Ming-Yuan

doi:10.1016/s0929-6646(08)60060-1

Cited by 23 publications

(23 citation statements)

References 22 publications

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“…42Y44 Adding to this knowledge base, we found that a previous suicide attempt was a strong predictor of poor response to antidepressant treatment even after adjusting for baseline characteristics associated with this history, including baseline severity of depression. A few studies have suggested that suicide attempts or ideation may predict relapse in depression, 45,46 but to our knowledge, ours is the first study to report a prospective association with poor treatment outcomes in a large prospective Asian cohort. A pharmacogenetic study with escitalopram and nortriptyline in the United Kingdom found that, contrary to our findings, a history of suicide attempts was not associated with differences in treatment responses.…”

Section: Discussionmentioning

confidence: 66%

Relationship Between a History of a Suicide Attempt and Treatment Outcomes in Patients With Depression

Kim¹,

Stewart²,

Kim³

et al. 2011

Journal of Clinical Psychopharmacology

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This study aimed to investigate the sociodemographic and clinical correlates of a history of a suicide attempt in people with depression and their relationship with treatment outcomes and subsequent suicidal ideation and deliberate self-harm. Patients with depressive disorders according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, were recruited from 18 hospitals across South Korea. Data on sociodemographic and clinical characteristics were obtained, and scales assessing depression, anxiety, and general functioning were administered during the first 12 weeks of antidepressant treatment. Baseline characteristics, responses to treatment, and suicidal ideation/deliberate self-harm during the follow-up period were compared according to a reported history or not of a suicide attempt. In a total of 723 participants, 143 (19.8%) with a history of a suicide attempt had an earlier age of onset, longer duration of illness, and a greater number of depressive episodes. Levels of depression and anxiety were significantly higher at baseline in this group who also experienced significantly lower remission and response rates, as well as longer time to remission. The case group was more likely to experience new suicidal ideation and carry out a deliberate self-harm act during the 12-week treatment period. In conclusion, a history of a suicide attempt in a Korean population with depression was characterized by more severe psychopathology, poorer treatment outcomes, and higher subsequent suicidal ideation and self-harm. Therefore, more intensive and longer-term treatment with particular ongoing clinical attention to risk is indicated in patients with these distinct, chronic, and severe forms of depression and ongoing high suicide risk.

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Section: Discussionmentioning

confidence: 66%

Relationship Between a History of a Suicide Attempt and Treatment Outcomes in Patients With Depression

Kim¹,

Stewart²,

Kim³

et al. 2011

Journal of Clinical Psychopharmacology

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“…Over the past several decades, the LOS for patients requiring psychiatric hospitalisation has decreased from months to weeks, driven not only by economic pressures but by advances in clinical practice with a focus on treatment in outpatient settings [13–15]. There is some debate as to the optimum LOS in psychiatric patients; some studies argue that patients with depression who are discharged after a brief inpatient treatment are more depressed and more globally impaired on discharge [13], while other studies suggest that shorter stay is as effective or more effective than long-term inpatient programmes among depressed patients [16,17], or patients with severe mental illness [18]. …”

Section: Discussionmentioning

confidence: 99%

Hospital stay in patients admitted for acute bipolar manic episodes prescribed quetiapine immediate or extended release: a retrospective non-interventional cohort study (HOME)

et al. 2014

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BackgroundBipolar manic episodes often require hospital admission to ensure patient safety. The antipsychotic quetiapine is a common treatment for bipolar mania and is available in immediate release (IR) and extended release (XR) formulations; however, outcomes in patients receiving these different formulations have not been directly compared in an acute hospital setting.MethodsWe conducted a multinational, observational, retrospective cohort study to describe and compare hospital stay in patients admitted for an acute bipolar manic episode treated with quetiapine IR or XR from 1 October 2009–1 October 2010. The primary outcome measure was comparison of length of stay (LOS) using zero-truncated negative binomial regression.ResultsIn total, 1230 patients were included (659 in the IR cohort; 571 in the XR cohort). The median LOS (interquartile range) was 18.0 days (12.0, 28.0) in the IR cohort and 20.0 days (12.0, 34.0) in the XR cohort, respectively. LOS was not significantly associated with quetiapine formulation irrespective of whether or not clinical characteristics were taken into account (p = 0.820 and p = 0.386, respectively). Overall, 84.2% and 84.4% of patients in the IR and XR cohorts, respectively, had not previously used quetiapine; of these patients, 78.7% and 68.9% received one total daily dose, and 14.4% and 23.9% received dose titration. Over half of patients received antipsychotic monotherapy (53.1% and 58.3% in the IR and XR cohorts, respectively) and most received a daily quetiapine dose ≥ 400 mg (64.9% and 71.8%, respectively, for quetiapine monotherapy and 59.9% and 80.3%, respectively, for combination treatment).As a secondary outcome, multivariate analysis was used to identify other factors that affect LOS. Factors associated with a longer hospital stay included public funding versus private, maximum number of new medications administered, did not receive lithium and did not receive anxiolytics, sedatives/hypnotics (all p < 0.0001). Factors associated with a shorter hospital stay included presence of drug/alcohol abuse, living accompanied and having a psychiatric medical history (all p < 0.05).ConclusionsLOS was not found to be associated with quetiapine formulation. However, most patients received only one total daily dose of quetiapine without dose titration, which was unexpected and contrary to current recommendations.Trial registrationTrial registration: NCT01239589Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-014-0246-3) contains supplementary material, which is available to authorized users.

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“…Yaş, hastalık süresi, atak sayısı, başlangıç yaşı, ailede psikiyatrik hastalık hikayesi (özellikle depresyon), cinsiyet, medeni durum ve eğitim gibi sosyodemografik değişkenlerin AD tedaviye cevabı öngöremediklerini bildiren birçok çalışmada bulunmaktadır (11,31,35,51,55,56,57). Depresyonda AD tedaviye cevabı öngörebilmek için, hastaların sosyodemografik ve hastalık özelliklerini araştıran ve birbirleriyle çelişen çalışmalar arasında ortaya çıkan tutarsızlık, bu çalışmalarda kullanılan farklı çalışma desenlerine ve buna bağlı oluşan hasta gruplarına, denek sayısına, tercih edilen ilaç tedavilerine, takip süresine ve ölçüm araçlarına bağlı olabilir.…”

Section: Discussionunclassified

“…Literatür verisi çalışmamızda ulaşılan sonuç ile doğru orantılıdır. Kuvvetli sosyal desteği bulunan ve sosyoekonomik durumu iyi olan depresyon hastalarının AD tedaviden daha fazla yararlandıkları ifade edilmektedir ayrıca kuvvetli sosyal desteğin olumsuz yaşam olaylarının depresojenik etkisini tamponize ettiği de belirtilmektedir (34,42,57,60).…”

Section: Discussionunclassified

Majör Depresif Bozuklukta Düzelmenin Öngörücüleri

Akkaya¹,

Eker²,

Sarandöl³

et al. 2013

npa

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Ya z›fl ma Ad re si/Cor res pon den ce Ad dress: Dr. Cengiz Akkaya, Uludağ Üniversitesi Tıp Fakültesi, Psikiyatri Anabilim Dalı, Bursa, Türkiye Gsm: +90 532 257 64 80 E-posta: cakkaya@uludag.edu.tr Ge liş ta ri hi/Re cei ved: 15.08.2011 Ka bul ta ri hi/Ac cep ted: 12.01.2012 © Nö rop si ki yat ri Ar şi vi Der gi si, Ga le nos Ya yı ne vi ta ra f›n dan ba s›l m›fl t›r. / © Arc hi ves of Neu ropsy chi atry, pub lis hed by Ga le nos Pub lis hing ÖZET Amaç: Bu çalışmada antidepresan (AD) tedavi ile Majör Depresif Bozuklukta (MDB) düzelmenin öngörücülerinin araştırılması amaçlanmıştır. Yöntem: Bu çalışmanın örneklemi, MBD'de AD etkinliğini araştıran, 4 çalışmaya ait veri havuzundan oluşturulmuştur. Bu çalışmada 178 hasta, son vizit olan vizit 5'te düzelip düzelmediklerine göre 2 gruba ayrıldı. Böylelikle hastalar kullandıkları AD'den bağımsız olarak sosyodemografik ve klinik özellikleri açısından birbirleriyle karşılaştırıldı. Bulgular: Düzelen ve düzelmeyen hastalar arasında sosyodemografik ve hastalık özellikleri açısından herhangi bir fark bulunamamıştır. Beşinci vizitte düzelen hastaların düzelmeyenlere göre birinci vizitte daha düşük Hamilton Depresyon Derecelendirme Ölçeği (HAM-D), Montgomery-Asberg Depresyon Değerlendirme Ölçeği, Hamilton Anksiyete Değerlendirme Ölçeği ve Klinik Global Değerlendirme Ölçeği-Hastalığın Şiddeti değerleri ile daha yüksek Sosyal Uyum Kendini Değerlendirme Ölçeği (SUKDÖ) değeri gösterdikleri tespit edilmiştir. Tedavinin başındaki ölçek değerlerinin (HAM-D ve SUKDÖ) düzelememe üzerinde bir risk faktörü olup olmadıklarını belirlemek amacıyla oluşturulan lojistik regresyon modeli anlamlı bulunmuştur (χ2=22,692 p<0,001). Bu model için düzelememe değişkeninin doğru sınıflandırma oranı %66'dir. Modelde 1. vizit HAM-D ve SUKDÖ ölçek değerleri, istatistiksel olarak anlamlı risk faktörleridir (p<0,001). HAM-D değişken değeri artıkça düzelememe riski 1,095 (Odds oranı için %95 güven aralığı: 1,045-1,147) kat artarken, SUKDÖ değişken değerinin düşük olması ise riski 1,076 (Odds oranı için %95 güven aralığı: 1,042-1,114) kat artırır. Bu model aracılığıyla her bir birey için düzelememe olasılığı "p(Düzelememe)=1/[(1+exp(-0,093×V1HAM-D+0,075×V1SUKDÖ)]" eşitliği kullanılarak tahmin edilebilir. Sonuç: AD tedavi ile düzelmeyi öngörmekte başlangıçta kaydedilen depresyonun, anksiyetenin ve sosyal uyum bozukluğunun şiddet düzeyinin etkili olduğu saptanmıştır. ( Nöropsikiyatri Arşivi 2013; 50: 122-129) Anah tar ke li me ler: Majör depresif bozukluk, düzelme, antidepresan Çıkar çatışması: Yazarlar bu makale ile ilgili olarak herhangi bir çıkar çatışması bildirmemişlerdir. ABS TRACT Background:We aimed to determine the predictors of remission in major depressive disorder (MDD) with antidepressant treatment (AT). Methods:The subjects were recruited from the databases of the previous four studies. 178 patients were separated in to two groups at the final visit regarding remission. The patients were analyzed in terms of sociodemographic and clinical features regardless of their AT. Results:The difference in s...

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Predictors of Treatment Response and Length of Stay for Inpatients with Major Depression

Cited by 23 publications

References 22 publications

Relationship Between a History of a Suicide Attempt and Treatment Outcomes in Patients With Depression

Relationship Between a History of a Suicide Attempt and Treatment Outcomes in Patients With Depression

Hospital stay in patients admitted for acute bipolar manic episodes prescribed quetiapine immediate or extended release: a retrospective non-interventional cohort study (HOME)

Majör Depresif Bozuklukta Düzelmenin Öngörücüleri

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