Treatment-Resistant Depression in America Latina study: one-year follow-up of treatment resistant depression patients under standard of care reveals insights on quality of life, disability, work impairment, and depressive symptoms

Frontiers in Psychiatry

Psychiatry

Christian Lupo¹  Gerardo Garcia Bonetto²  Claudia Becerra-Palars³  Kelen Recco⁴  Arnulfo Morales⁵  Sergio Perocco⁶  Alanna Pfau⁷  Antonio E. Nardi⁸ 

[1] Centro de Investigación y Asistencia en Psiquiatria, Rosario, Argentina;Hospital Neuropsiquiatrico Provincial de Córdoba, Córdoba, Argentina;Instituto Nacional de Psiquiatría “Ramón de la Fuente Muñiz”, Mexico City, Mexico;Instituto de Neurociências Dr João Quevedo, Criciúma, Santa Catarina, Brazil;Instituto de Seguridad Social del Estado de México y Municipios, Toluca, Mexico;Janssen Cilag Farmacêutica Ltda, São Paulo, Brazil;Janssen, Pharmaceutical Companies, Titusville, NJ, United States;Outpatient Clinic for Resistant Depression, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil;

关键词: treatment-resistant depressive disorder;    longitudinal study;    quality of life;    standard of care;    patient reported outcome measures;    Latin America;   

DOI  :  10.3389/fpsyt.2023.1221746

 received in 2023-05-12, accepted in 2023-10-03,  发布年份 2023

来源: Frontiers

【 摘 要 】

IntroductionDepressive Disorders are on the rise worldwide. This is also the case in Latin America (LatAm). Treatment-Resistant Depressive Disorder (TRD) poses additional burden to patients with depression. Impacts quality of life (QoL) and other dimensions, and standard of care (SOC) is insufficient to achieve the desired clinical outcomes. Evidence from LatAm is, however, lacking. The present study was devised as a 1-year follow-up of the SOC in TRD patients in LatAm to explore the burden of TRD.MethodsThis was an observational, multinational, longitudinal study. Patients with clinical diagnosis of TRD in LatAm were included in a 1-year follow-up with SOC. Beyond the Sociodemographic characterization, outcome measures were QoL (EQ-5D-5L), disability (Sheehan Disability Scale - SDS), work productivity (Work Productivity and Activity Incapacity Questionnaire: depression - WPAI:D) and depression severity (Patient Health Questionnaire-PHQ9). Patients were assessed every 3-months and comparison was performed based on change from baseline to each visit and end of study (EOS - 12 months).ResultsPatients averaged 48 (± 13.12) years, mostly female (80.9%) and married/consensual union (42.5%) or single patients (34.4%). Despite the SOC treatment, three-quarters of the patients remained symptomatic at EOS, regardless of the significant longitudinal decrease (p ≤ 0.001). Similar trends were found for disability (p ≤ 0.001) -82.2% of the patients reporting work/school disruption at EOS-, percentage of work (34%) and activity impairment (40%) at EOS (p ≤ 0.001) and only 29.2% of patients with depressive severity “none” at EOS (p ≤ 0.001). The results portray the need to improve clinical outcomes in this complex and burdensome disease in LatAm.DiscussionHere we show that the burden of TRD remains significant in essential dimensions of everyday life at EOS underlining the need for better therapeutic solutions. The improvements in most patients do not provide the desired outcome of return to the state before the condition. Further research should focus on identifying which treatments provide better outcomes in a real-world context.

【 授权许可】

Unknown   
Copyright © 2023 Recco, Bonetto, Lupo, Nardi, Morales, Becerra-Palars, Perocco and Pfau.