Patient-reported outcomes before and after treatment of major depressive disorder

• Published in: Dialogues in clinical neuroscience Vol. 16; no. 2; pp. 171 - 183
• Main Authors: IsHak, Waguih William, Mirocha, James, Pi, Sarah, Tobia, Gabriel, Becker, Bret, Peselow, Eric D., Cohen, Robert M.
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 01.06.2014; Les Laboratoires Servier
• Subjects: Adolescent; Adult; Aged; Clinical Research; Databases, Factual - statistics & numerical data; Depressive Disorder, Major - psychology; Depressive Disorder, Major - therapy; Female; functioning; Humans; individual burden of illness; major depressive disorder; Male; Middle Aged; Patient Outcome Assessment; Psychiatric Status Rating Scales; Quality of Life; Retrospective Studies; Self Report; Severity of Illness Index; STARD; Treatment Outcome; United States; Young Adult; United States; functioning; STARD; individual burden of illness; major depressive disorder; quality of life
• ISSN: 1958-5969; 1294-8322; 1958-5969
• DOI: 10.31887/DCNS.2014.16.2/rcohen

Patient reported outcomes (PROs) of quality of life (QoL), functioning, and depressive symptom severity are important in assessing the burden of illness of major depressive disorder (MDD) and to evaluate the impact of treatment. We sought to provide a detailed analysis of PROs before and after treatment of MDD from the large Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study. This analysis examines PROs before and after treatment in the second level of STAR*D. The complete data on QoL, functioning, and depressive symptom severity, were analyzed for each STAR*D level 2 treatment. PROs of QoL, functioning, and depressive symptom severity showed substantial impairments after failing a selective serotonin reuptake inhibitor trial using citalopram (level 1). The seven therapeutic options in level 2 had positive statistically (P values) and clinically (Cohen's standardized differences [Cohen's d]) significant impact on QoL, functioning, depressive symptom severity, and reduction in calculated burden of illness. There were no statistically significant differences between the interventions. However, a substantial proportion of patients still suffered from patient-reported QoL and functioning impairment after treatment, an effect that was more pronounced in nonremitters. PROs are crucial in understanding the impact of MDD and in examining the effects of treatment interventions, both in research and clinical settings.