Residual symptoms and functioning in depression, does the type of residual symptom matter? A post-hoc analysis

BMC Psychiatry

Inmaculada Gilaberte⁵  Pepa Polavieja⁵  Miguel Roca³  Luis Caballero⁴  Antonio Ciudad⁵  Víctor Pérez¹  Irene Romera² 

[1] Department of Psychiatry, Hospital Santa Creu i Sant Pau, Autonomous University of Barcelona / CIBERSAM, Barcelona, Spain;Autonomous University of Barcelona, Barcelona, Spain;Department of Psychiatry, Joan March Hospital, Rediapp, Palma de Mallorca, Spain;Department of Psychiatry, Hospital Puerta de Hierro, Madrid, Spain;Department of Clinical Research Lilly, S.A. Avenida de la Industria 30, 28108, Alcobendas, Spain

关键词: Functioning;    Major depression;    Residual symptoms;   

Others  :  1124142
DOI  :  10.1186/1471-244X-13-51

 received in 2013-01-23, accepted in 2013-01-30,  发布年份 2013

【 摘 要 】

Background

The degrees to which residual symptoms in major depressive disorder (MDD) adversely affect patient functioning is not known. This post-hoc analysis explored the association between different residual symptoms and patient functioning.

Methods

Patients with MDD who responded (≥50% on the 17-item Hamilton Rating Scale for Depression; HAMD-17) after 3 months of treatment (624/930) were included. Residual core mood-symptoms (HAMD-17 core symptom subscale ≥1), residual insomnia-symptoms (HAMD-17 sleep subscale ≥1), residual anxiety-symptoms (HAMD-17-anxiety subscale ≥1), residual somatic-symptoms (HAMD-17 Item 13 ≥1), pain (Visual Analogue Scale ≥30), and functioning were assessed after 3 months treatment. A stepwise logistic regression model with normal functioning (Social and Occupational Functioning Assessment Scale ≥80) as the dependent variable was used.

Results

After 3 months, 59.5% of patients (371/624) achieved normal functioning and 66.0% (412/624) were in remission. Residual symptom prevalence was: core mood symptoms 72%; insomnia 63%; anxiety 78%; and somatic symptoms 41%. Pain reported in 18%. Factors associated with normal functioning were absence of core mood symptoms (odds ratio [OR] 8.7; 95% confidence interval [CI], 4.6–16.7), absence of insomnia symptoms (OR 1.8; 95% CI, 1.2–2.7), episode length (4–24 weeks vs. ≥24 weeks [OR 2.0; 95% CI, 1.1–3.6]) and better baseline functioning (OR 1.0; 95% CI, 1.0–1.1). A significant interaction between residual anxiety symptoms and pain was found (p = 0.0080).

Conclusions

Different residual symptoms are associated to different degrees with patient functioning. To achieve normal functioning, specific residual symptoms domains might be targeted for treatment.

【 授权许可】

   
2013 Romera et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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