Residual symptoms and functioning in depression, does the type of residual symptom matter? A post-hoc analysis
Romera, Irene (Lilly S.A. (Alcobendas, Madrid))
Pérez Solà, Víctor (Institut d'Investigació Biomèdica Sant Pau)
Ciudad, Antonio (Lilly S.A. (Alcobendas, Madrid))
Caballero, Luis (Hospital Universitario Puerta de Hierro Majadahonda (Madrid))
Roca, Miguel (Joan March Hospital)
Polavieja, Pepa (Lilly S.A. (Alcobendas, Madrid))
Gilaberte, Inmaculada (Lilly S.A. (Alcobendas, Madrid))
Universitat Autònoma de Barcelona

Data:	2013
Resum:	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. © 2013 Romera et al. ; licensee BioMed Central Ltd.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Functioning ; Major depression ; Residual symptoms
Publicat a:	BMC Psychiatry, Vol. 13 (november 2013) , p. 51, ISSN 1471-244X

DOI: 10.1186/1471-244X-13-51
PMID: 23398902

7 p, 219.7 KB

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Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut de Recerca Sant Pau
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