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Social and occupational functioning impairment in patients in partial versus complete remission of a major depressive disorder episode. A six-month prospective epidemiological study

Published online by Cambridge University Press:  16 April 2020

I. Romera ,
V. Perez ,
J.M. Menchón ,
H. Delgado-Cohen ,
P. Polavieja  and
I. Gilaberte
I. Romera*
Affiliation:
Clinical Research Department, Lilly, SA, Avenida de la Industria, 30, Alcobendas, 28108Madrid, Spain
V. Perez
Affiliation:
Department of Psychiatry, Hospital de Sant Pau i de la Santa Creu, C/Sant Antoni Maria Claret, CIBERSAM, 167, 08025Barcelona, Spain
J.M. Menchón
Affiliation:
Department of Psychiatry, Hospital Universitari de Bellvitge, Feixa Llarga sn, Hospitalet de Llobregat, CIBERSAM, 08907Barcelona, Spain
H. Delgado-Cohen
Affiliation:
Clinical Research Department, Lilly, SA, Avenida de la Industria, 30, Alcobendas, 28108Madrid, Spain
P. Polavieja
Affiliation:
Clinical Research Department, Lilly, SA, Avenida de la Industria, 30, Alcobendas, 28108Madrid, Spain
I. Gilaberte
Affiliation:
Clinical Research Department, Lilly, SA, Avenida de la Industria, 30, Alcobendas, 28108Madrid, Spain
*
*Corresponding author. Tel.: +34 91 663 50 00; fax: +34 91 663 52 31. E-mail address: romera_irene@lilly.com (I. Romera).
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Abstract

Purpose

To evaluate social and occupational functioning in patients in partial remission (PR) compared with patients in complete remission (CR) of a major depressive disorder (MDD) episode.

Subjects and methods

This is a six-month prospective study. PR was defined as a score more than 7 and less or equal to 15 in the Hamilton Depression Rating Scale, and CR as less or equal to 7. All patients had been on acute antidepressant treatment during the previous three months and no longer met criteria for MDD. Functioning was assessed by the Social and Occupational Functioning Assessment Scale (SOFAS).

Results

Mean (S.D.) patient age was 50.5 (14.5) years (N = 292) and 77% were female. At baseline, partial remitters showed greater impairment in social and occupational functioning than complete remitters (62.8 [12.6] versus 80.4 [10.5], respectively; P < .0001). After six months, only 47% PR versus 77% CR reached normal functioning, and SOFAS ratings for PR were below normal range (76.2 [12.3] PR versus 84.6 [9.4] CR; P < .0001). PR reported three times more days absent from work due to sickness than CR (63 days versus 20 days; P < .001).

Conclusion

We conclude that PR of an MDD episode is associated with significant functional impairment that persists even after nine months of antidepressant treatment. Our results underline the importance of treating the patient until achieving full remission.

Keywords

Major depressive disorderSocial and occupational functioningPartial remission
Type
Original articles
Information
European Psychiatry , Volume 25 , Issue 1 , January 2010 , pp. 58 - 65
Copyright
Copyright © Elsevier Masson SAS 2010

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References

Broadhead, W.E., Blazer, D.G., George, L.K., Tse, C.K.Depression, disability days, and days lost from work in a prospective epidemiologic survey. JAMA 1990;264:2524–2528.CrossRefGoogle Scholar
Corey-Lisle, P.K., Nash, R., Stang, P., Swindle, R.Response, partial response, and nonresponse in primary care treatment of depression. Arch Intern Med 2004;164:1197–1204.CrossRefGoogle ScholarPubMed
De Lisio, G., Maremmani, I., Perugi, G.Impairment of work and leisure in depressed outpatients. J Affect Disord 1986;10:79–84.CrossRefGoogle ScholarPubMed
Doraiswamy, P.M., Khan, Z.M., Donahue, R.M., Richard, N.E.Quality of life in geriatric depression: a comparison of remitters, partial responders, and nonresponders. Am J Geriatr Psychiatry 2001;9:423–428.CrossRefGoogle ScholarPubMed
Frank, E., Prien, R.F., Jarrett, R.B., Keller, M.B., Kupfer, D.J., Lavori, P.W.et al. Conceptualization and rationale for consensus definitions of terms in major depressive disorder. Remission, recovery, relapse, and recurrence. Arch Gen Psychiatry 1991;48:851–855.CrossRefGoogle ScholarPubMed
Furukawa, T.A., Takeuchi, H., Hiroe, T., Mashiko, H., Kamei, K., Kitamura, T.et al. Symptomatic recovery and social functioning in major depression. Acta Psychiatr Scand 2001;103:257–261.CrossRefGoogle ScholarPubMed
Goldman, H.H., Skodol, A.E., Lave, T.R.Revising axis V for DSM-IV: a review of measures of social functioning. Am J Psychiatry 1992;149:1148–1156.Google ScholarPubMed
Guy, W. ECDEU Assessment Manual for Psychopharmacology, [Revised]. Rockville: National Institute of Mental Health, Dept of Health, Education, and Welfare publication (ADM); 1976, p. 76–338.Google Scholar
Hamilton, M.A rating scale for depression. J Neurol Neurosurg Psychiatry 1960;23:56–62.CrossRefGoogle ScholarPubMed
Hamilton, M.Development of a rating scale for primary depressive illness. Br J Soc Clin Psychol 1967;6:278–296.CrossRefGoogle ScholarPubMed
Hays, R.D., Wells, K.B., Sherbourne, C.D., Rogers, W., Spritzer, K.Functioning and well-being outcomes of patients with depression compared with chronic general medical illnesses. Arch Gen Psychiatry 1995;52:11–19.CrossRefGoogle ScholarPubMed
Hodgson, T.A., Meiners, M.R.Cost-of-illness methodology: a guide to current practices and procedures. Milbank Mem Fund Q Health Soc 1982;60:429–462.CrossRefGoogle ScholarPubMed
Judd, L.L., Akiskal, H.S., Maser, J.D., Zeller, P.J., Endicott, J., Coryell, W.et al. Major depressive disorder: a prospective study of residual subthreshold depressive symptoms as predictor of rapid relapse. J Affect Disord 1998;50:97–108.CrossRefGoogle ScholarPubMed
Judd, L.L., Paulus, M.P., Wells, K.B., Rapaport, M.H.Socioeconomic burden of subsyndromal depressive symptoms and major depression in a sample of the general population. Am J Psychiatry 1996;153:1411–1417.Google Scholar
Keller, M.B.Past, present, and future directions for defining optimal treatment outcome in depression: remission and beyond. JAMA 2003;289:3152–3160.CrossRefGoogle ScholarPubMed
Kennedy, N., Foy, K., Sherazi, R., McDonough, M., McKeon, P.Long-term social functioning after depression treated by psychiatrists: a review. Bipolar Disord 2007;9:25–37.CrossRefGoogle ScholarPubMed
Kocsis, J.H., Schatzberg, A., Rush, A.J., Klein, D.N., Howland, R., Gniwesch, L.et al. Psychosocial outcomes following long-term, double-blind treatment of chronic depression with sertraline vs placebo. Arch Gen Psychiatry 2002;59:723–728.CrossRefGoogle ScholarPubMed
Miller, I.W., Keitner, G.I., Schatzberg, A.F., Klein, D.N., Thase, M.E., Rush, A.J.et al. The treatment of chronic depression, part 3: psychosocial functioning before and after treatment with sertraline or imipramine. J Clin Psychiatry 1998;59:608–619.CrossRefGoogle ScholarPubMed
Mintz, J., Mintz, L.I., Arruda, M.J., Hwang, S.S.Treatments of depression and the functional capacity to work. Arch Gen Psychiatry 1992;49:761–768.CrossRefGoogle ScholarPubMed
Nierenberg, A.A., Wright, E.C.Evolution of remission as the new standard in the treatment of depression. J Clin Psychiatry 1999;60:7–11.Google ScholarPubMed
Opdyke, K.S., Reynolds, C.F., Frank, E., Begley, A.E., Buysse, D.J., Dew, M.A.et al. Effect of continuation treatment on residual symptoms in late-life depression: how well is “well”?. Depress Anxiety 1996–1997;4 312–319.3.0.CO;2-D>CrossRefGoogle Scholar
Papakostas, G.I., Petersen, T., Denninger, J.W., Tossani, E., Pava, J.A., Alpert, J.E.et al. Psychosocial functioning during the treatment of major depressive disorder with fluoxetine. J Clin Psychopharmacol 2004;24:507–511.CrossRefGoogle ScholarPubMed
Paykel, E.S., Ramana, R., Cooper, Z., Hayhurst, H., Kerr, J., Barocka, A.Residual symptoms after partial remission: an important outcome in depression. Psychol Med 1995;25:1171–1180.CrossRefGoogle ScholarPubMed
Paykel, E.S., Weissman, M., Prusoff, B.A., Tonks, C.M.Dimensions of social adjustment in depressed women. J Nerv Ment Dis 1971;152:158–172.CrossRefGoogle ScholarPubMed
Romera, I, Delgado-Cohen, H, Perez, V, Menchon, JM, Polavieja, P, Yruretagoyena, B, Gilaberte, I. Optimal cutoff point to define remission by the Hamilton Rating Scale for Depression according to normal social and occupational functioning. Presented as a poster at the International Forum of Mood and Anxiety Disorders (IFMAD) 2007. Budapest.Google Scholar
Salminen, J.K., Saarijärvi, S., Raitasalo, R.Depression and disability pension in Finland. Acta Psychiatr Scand 1997;95:242–243.CrossRefGoogle ScholarPubMed
Sobocki, P., Ekman, M., Agren, H., Runeson, B., Jönsson, B.The mission is remission: health economic consequences of achieving full remission with antidepressant treatment for depression. Int J Clin Pract 2006;60:791–798.CrossRefGoogle ScholarPubMed
Spitzer, R.L., Gibbon, M., Endicott, J.Global Assessment Scale (GAS), Global Assessment of Functioning (GAF) Scale, Social and Occupational Functioning Assessment Scale (SOFAS). Mental Health Status, Functioning and Disability Measures. First, M.B., Handbook of psychiatric measures, 1st ed. Washington DC, USA: American Psychiatric Association; 2000. 96–100.Google Scholar
Wells, K.B., Stewart, A., Hays, R.D., Burnam, M.A., Rogers, W., Daniels, M.et al. The functioning and well-being of depressed patients. Results from the Medical Outcomes Study. JAMA 1989;262:914–919.CrossRefGoogle ScholarPubMed
Zimmerman, M., McGlinchey, J.B., Posternak, M.A., Friedman, M., Boerescu, D., Attiullah, N.Discordance between self-reported symptom severity and psychosocial functioning ratings in depressed outpatients: implications for how remission from depression should be defined. Psychiatry Res 2006;141:185–191.CrossRefGoogle ScholarPubMed
Zimmerman, M., Posternak, M.A., Chelminski, I.Is the cutoff to define remission on the Hamilton Rating Scale for Depression too high?. J Nerv Ment Dis 2005;193:170–175.CrossRefGoogle ScholarPubMed
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