Residual cognitive and psychosocial functional impairment in outpatients in Greece who responded to conventional antidepressant monotherapy treatments for major depressive disorder (MDD).


Journal

Journal of affective disorders
ISSN: 1573-2517
Titre abrégé: J Affect Disord
Pays: Netherlands
ID NLM: 7906073

Informations de publication

Date de publication:
01 10 2022
Historique:
received: 12 04 2022
revised: 28 06 2022
accepted: 05 07 2022
pubmed: 12 7 2022
medline: 11 8 2022
entrez: 11 7 2022
Statut: ppublish

Résumé

Patients with MDD may experience diverse residual symptoms after clinical response to antidepressant treatment. Among these symptoms, cognitive problems in executive functioning are prominent and make functional recovery largely an unmet need for MDD patients. In this study we assessed cognitive symptoms and functional impairment in patients with MDD responding to antidepressant treatment. This was a national, multi-site, non-interventional, cross-sectional study of depressive symptomatology, cognitive performance and psychosocial functioning in Greek outpatients with MDD who had clinically responded to antidepressant treatment. Both clinician- and patient- rated measures were employed. Symptom remission was assessed with the Montgomery Asberg Depression Rating Scale (MADRS) total score (≤12) and functional recovery was assessed with the Sheehan Disability Scale (SDS) score (<6). 335 MDD patients participated in the study. After antidepressant monotherapy approximately 60 % of responders and 40 % of remitted patients did not meet the functional recovery criterion. More than 60 % of responders had concentration difficulties as assessed by MADRS item. Patient reported cognitive symptoms were statistically significantly associated with functionality (β coefficient = 0.126, p-value = 0.027). Non-interventional study design and lack of a control group or active comparator/reference. This study highlights the persistence of decreased cognitive performance, particularly in executive functioning in patients with MDD who have shown response and/or remission to antidepressant treatment. This appears to contribute to psychosocial functional impairment. Patient-reported cognitive and psychosocial functioning impairment should be included in routine clinical monitoring of outcomes in MDD treatments.

Sections du résumé

BACKGROUND
Patients with MDD may experience diverse residual symptoms after clinical response to antidepressant treatment. Among these symptoms, cognitive problems in executive functioning are prominent and make functional recovery largely an unmet need for MDD patients. In this study we assessed cognitive symptoms and functional impairment in patients with MDD responding to antidepressant treatment.
METHODS
This was a national, multi-site, non-interventional, cross-sectional study of depressive symptomatology, cognitive performance and psychosocial functioning in Greek outpatients with MDD who had clinically responded to antidepressant treatment. Both clinician- and patient- rated measures were employed. Symptom remission was assessed with the Montgomery Asberg Depression Rating Scale (MADRS) total score (≤12) and functional recovery was assessed with the Sheehan Disability Scale (SDS) score (<6).
RESULTS
335 MDD patients participated in the study. After antidepressant monotherapy approximately 60 % of responders and 40 % of remitted patients did not meet the functional recovery criterion. More than 60 % of responders had concentration difficulties as assessed by MADRS item. Patient reported cognitive symptoms were statistically significantly associated with functionality (β coefficient = 0.126, p-value = 0.027).
LIMITATIONS
Non-interventional study design and lack of a control group or active comparator/reference.
CONCLUSIONS
This study highlights the persistence of decreased cognitive performance, particularly in executive functioning in patients with MDD who have shown response and/or remission to antidepressant treatment. This appears to contribute to psychosocial functional impairment. Patient-reported cognitive and psychosocial functioning impairment should be included in routine clinical monitoring of outcomes in MDD treatments.

Identifiants

pubmed: 35817305
pii: S0165-0327(22)00771-6
doi: 10.1016/j.jad.2022.07.009
pii:
doi:

Substances chimiques

Antidepressive Agents 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

185-192

Informations de copyright

Copyright © 2022 Elsevier B.V. All rights reserved.

Auteurs

E Papalexi (E)

Lundbeck Hellas, Athens, Greece.

A Galanopoulos (A)

Lundbeck Hellas, Athens, Greece.

D Roukas (D)

Department of Psychiatry, 417 Army Equity Fund Hospital (NIMTS) Hospital, Athens, Greece.

I Argyropoulos (I)

Psychiatrist, Thessaloniki, Greece.

I Michopoulos (I)

Second Department of Psychiatry, Attikon General Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece.

A Douzenis (A)

Second Department of Psychiatry, Attikon General Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece.

I Gkolia (I)

Psychiatric Hospital of Thessaloniki, Stavroupolis, 56429 Thessaloniki, Greece.

P Fotiadis (P)

Psychiatrist, Thessaloniki, Greece.

D Kontis (D)

4th Psychiatric Department, Psychiatric Hospital of Attica, Athens, Greece.

I M Zervas (IM)

First Department of Psychiatry, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece. Electronic address: yanizervas@gmail.com.

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Classifications MeSH