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Verma A, Malhotra A, Ranjan P, Kumari A, Chopra S, Khan MA, Kaloiya GS, Singh A, Prakash B, Ahuja M. A comprehensive evaluation of predictors of obesity in women during the perimenopausal period: A systematic review and narrative synthesis. Diabetes Metab Syndr 2024; 18:102933. [PMID: 38181722 DOI: 10.1016/j.dsx.2023.102933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 11/16/2023] [Accepted: 12/17/2023] [Indexed: 01/07/2024]
Abstract
INTRODUCTION Obesity during perimenopausal transition can be attributed to various factors. Identifying these factors is crucial in preventing obesity and developing effective strategies to manage weight during this phase. This review aimed to systematically understand predictors of obesity during menopausal transition. METHODS The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and searched databases like PubMed, Wiley Online Library, and Cochrane Reviews. Cohort and cross-sectional studies in English language assessing obesity among menopausal women were included. The methodological quality was assessed using Joanna Briggs Checklist for critical appraisal. Risk of Bias (RoB) was generated using Review Manager 5.4.1 (RevMan). Identified predictors were assessed for overall quality of evidence using adopted Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. RESULTS This review encompassed 42 studies, (21 cross-sectional and 21 cohort) with sample ranging from 164 to 107,243 across studies. Higher parity( ≥ 3 children) emerged as a strong predictor of obesity across seven studies, with good-quality evidence. Lower physical activity was another predictor, supported by eight studies with good-quality evidence. Sociodemographic factors like lower education(<8 years or < than college degree), socioeconomic background, menopausal transition, and older age at menarche showed associations with weight gain, with moderate-quality evidence. Lifestyle factors (high-fat consumption, sedentariness, active smoking status, and psychological difficulties) also showed moderate-quality evidence. CONCLUSION This review underscores the multifaceted factors associated with obesity during the perimenopausal transition. Identifying these factors will be helpful in prevention and management of obesity among these women.
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Affiliation(s)
- Aditi Verma
- Department of Home Science, University of Delhi, New Delhi, India
| | - Anita Malhotra
- Lakshmibai College, Department of Home Science, University of Delhi, New Delhi, India
| | - Piyush Ranjan
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.
| | - Archana Kumari
- Department of Obstetrics and Gynaecology, AIIMS, New Delhi, India
| | - Sakshi Chopra
- Department of Home Science, University of Delhi, New Delhi, India
| | - Maroof A Khan
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | | | - Amandeep Singh
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Bindu Prakash
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Maninder Ahuja
- Indian Menopause Society, Society of Meaningful Life Management, India
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Xu Z, Xie M, Wang Z, Chen H, Zhang X, Li W, Jiang W, Liu N, Zhang N. Altered brain functional network topology in Obsessive-Compulsive Disorder: A comparison of patients with varying severity of depressive symptoms and the impact on psychosocial functioning. Neuroimage Clin 2023; 40:103545. [PMID: 38006651 PMCID: PMC10755823 DOI: 10.1016/j.nicl.2023.103545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 11/07/2023] [Accepted: 11/14/2023] [Indexed: 11/27/2023]
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is associated with psychosocial impairment, which can be exacerbated by depressive symptoms. In this study, we employed graph theory analysis to investigate the association among neuroimaging, clinical features, and psychosocial functioning in OCD patients, with a specific focus on the differential impact of depressive symptoms. METHODS 216 OCD patients were divided into two subgroups based on depressive symptoms. Resting-state functional MRI data were acquired from a subset of 106 OCD patients along with 77 matched healthy controls (HCs). We analyzed the topological characteristics of the entire brain and the cognition-related subnetworks and performed Pearson correlation analyses to further explore the relationship with psychosocial functioning. RESULTS OCD patients with more severe depressive symptoms exhibited greater impairment across all dimensions of psychosocial functioning. Graph theory analysis revealed more pronounced reductions in network efficiency within the entire brain, the default mode network (DMN), and the cingulo-opercular network (CON) among patients with non or mild depressive symptoms. Lower nodal efficiency and degree centrality of the right superior temporal gyrus (STG) were found in OCD patients and these variables were positively correlated with psychosocial functioning impairment. CONCLUSIONS This study revealed that the presence of depressive symptoms generally exacerbated psychosocial functioning impairment in OCD patients. Abnormalities in the functional integration of the entire brain, the DMN, and the CON in OCD patients may comprise the basis of cognitive deficits, while dysfunction of the right STG may affect the psychosocial functioning through its role in emotion, intention perception, and insight.
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Affiliation(s)
- Zhihan Xu
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, China
| | - Minyao Xie
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, China
| | - Zhongqi Wang
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, China
| | - Haochen Chen
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, China
| | - Xuedi Zhang
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, China
| | - Wangyue Li
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, China
| | - Wenjing Jiang
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, China
| | - Na Liu
- Department of Medical Psychology, The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, China.
| | - Ning Zhang
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, China.
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Myklebost SB, Nordgreen T, Klakegg OS, Hammar Å. Long-term outcomes of an internet-delivered cognitive enhancement intervention targeting residual cognitive deficits after major depressive disorder: a 2-year follow-up of an open trial. Front Psychol 2023; 14:1194689. [PMID: 37655198 PMCID: PMC10466045 DOI: 10.3389/fpsyg.2023.1194689] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 07/25/2023] [Indexed: 09/02/2023] Open
Abstract
Background Cognitive deficits are common and disabling residual symptoms following major depressive disorder (MDD) and are related to increased risk of relapse. Residual cognitive deficits should thus be considered an important target for treatment. However, few have reported long-term outcomes of interventions targeting residual cognitive deficits. Objective This study aimed to (1) investigate change between pre-treatment and 2-year follow-up assessments in cognitive deficits, rumination, and symptoms of MDD after an internet-delivered intervention targeting residual cognitive deficits; (2) to investigate stability in outcomes between 6-month and 2-year follow-up assessments; (3) to report the number of participants' experiencing a new episode of MDD in the follow-up period; and (4) to investigate differences in outcomes between those who experienced a new episode of MDD and those who did not. Methods A total of 43 partly remitted adults were included to test a guided internet-delivered intervention, which consisted of 10 modules involving psychoeducation, cognitive strategies, and attention training. Participants were assessed at pre-treatment, post-treatment, after 6-months, and after 2-years, with measures assessing self-reported residual cognitive deficits, rumination, symptoms of MDD and relapse. Overall, 32 participants completed the 2-year follow-up assessment. Results Between the pre-treatment and 2-year follow-up assessments, there was a reduction in cognitive deficits and rumination, while there was an increase in symptoms of MDD. Cognitive deficits were stable between the 6-month and the 2-year follow-up, while there was an increase in rumination and symptoms of MDD. Thirteen of 32 participants reported a new episode of MDD during the follow-up period. The relapse group reported longer duration of MDD at pre-treatment and showed a difference in all outcomes after 2 years compared to the no-relapse group. The no-relapse group showed improvement in MDD symptoms at post-treatment, while the relapse group did not. Conclusion Delivering cognitive enhancement interventions over the internet is potentially related to stable improvements in residual cognitive deficits. The effects on rumination and symptoms of MDD are less certain. Lack of improvement in MDD symptoms after the intervention period should be investigated as an indicator of relapse. Results should be interpreted with caution due to the lack of control group and sample size.
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Affiliation(s)
- Sunniva Brurok Myklebost
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Biological and Medical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Tine Nordgreen
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Oda Stakkestad Klakegg
- Department of Biological and Medical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Åsa Hammar
- Department of Biological and Medical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
- Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden
- Office for Psychiatry and Habilitation, Psychiatry Research Skåne, Skåne, Sweden
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Wang M, Wei Z, Huang Q, Yang W, Wu C, Cao T, Zhao J, Lyu D, Wang F, Zhou N, Huang H, Zhang M, Chen Y, Xu Y, Ma W, Chen Z, Hong W. Prognostic prediction of subjective cognitive decline in major depressive disorder based on immune biomarkers: a prospective observational study. BMC Psychiatry 2023; 23:54. [PMID: 36658505 PMCID: PMC9850523 DOI: 10.1186/s12888-022-04513-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 12/30/2022] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE Subjective cognitive decline (SCD) is highlighted in patients with major depressive disorder (MDD), which impairs objective cognitive performance and worsens the clinical outcomes. Immune dysregulation is supposed to be the potential mechanism of cognitive impairment. However, the peripheral immune biomarkers in patients troubled with MDD and SCD are not conventionally described. METHODS A prospective-observational study was conducted for 8 weeks. Subjective cognitive function was measured using the Chinese version of the 20-item perceived deficits questionnaire-depression (PDQ-D) and depression symptoms were evaluated with Hamilton Depression Rating Scale-17 (HDRS-17). Luminex assays were used to measure 48 immune cytokines in plasma at baseline. Integrating these results and clinicopathological features, a logistic regression model was used to develop a prognostic prediction. RESULTS Totally, 114 patients were enrolled in this study. Among the patients who completed follow-up, 56% (N = 50) had residual subjective cognitive decline, and 44% (N = 50) did not. The plasma levels of FGF basic, INF-γ, IL-1β, MCP-1, M-CSF and SCF were increased and the levels of IL-9, RANTES and PDGF-BB were decreased in the SCD group. Additionally, Basic FGF, IFN-γ, IL-1β, and SCF were positively correlated and IL-9, RANTES, and PDGF-BB were negatively correlated with the PDQ-D scores after treatment. Notably, combinations of cytokines (SCF and PDGF-BB) and PDQ-D scores at baseline showed good performance (The area under the receiver operating characteristic curve = 0.818) in the prediction of subjective cognitive decline. CONCLUSION A prognostic model based on protein concentrations of SCF, PDGF-BB, and scores of PDQ-D showed considerable accuracy in predicting residual subjective cognitive decline in depression.
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Affiliation(s)
- Meiti Wang
- grid.16821.3c0000 0004 0368 8293Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030 China
| | - Zheyi Wei
- grid.16821.3c0000 0004 0368 8293Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030 China
| | - Qinte Huang
- grid.16821.3c0000 0004 0368 8293Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030 China
| | - Weijie Yang
- grid.16821.3c0000 0004 0368 8293Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030 China
| | - Chenglin Wu
- grid.24516.340000000123704535Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, 200120 China
| | - Tongdan Cao
- Shanghai Huangpu District Mental Health Center, Shanghai, 200040 China
| | - Jie Zhao
- Shanghai Huangpu District Mental Health Center, Shanghai, 200040 China
| | - Dongbin Lyu
- grid.16821.3c0000 0004 0368 8293Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030 China
| | - Fan Wang
- grid.16821.3c0000 0004 0368 8293Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030 China
| | - Ni Zhou
- grid.16821.3c0000 0004 0368 8293Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030 China
| | - Haijing Huang
- grid.16821.3c0000 0004 0368 8293Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030 China
| | - Mengke Zhang
- grid.16821.3c0000 0004 0368 8293Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030 China
| | - Yiming Chen
- grid.16821.3c0000 0004 0368 8293Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030 China
| | - Yi Xu
- grid.16821.3c0000 0004 0368 8293Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030 China
| | - Weiliang Ma
- grid.16821.3c0000 0004 0368 8293Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030 China
| | - Zheng Chen
- grid.16821.3c0000 0004 0368 8293Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030 China
| | - Wu Hong
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China. .,Shanghai Key Laboratory of Psychotic Disorders, Shanghai, 201108, China.
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Sumiyoshi T, Uchida H, Watanabe K, Oosawa M, Ren H, Moriguchi Y, Fujikawa K, Fernandez J. Validation and Functional Relevance of the Short Form of the Perceived Deficits Questionnaire for Depression for Japanese Patients with Major Depressive Disorder. Neuropsychiatr Dis Treat 2022; 18:2507-2517. [PMID: 36353465 PMCID: PMC9639589 DOI: 10.2147/ndt.s381647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 10/19/2022] [Indexed: 12/02/2022] Open
Abstract
Purpose To validate the five-item version of the Perceived Deficits Questionnaire for Depression (PDQ-D-5) for assessing subjective cognitive function in Japanese patients with major depressive disorder (MDD) using data from the PERFORM-J study. Patients and Methods A total of 518 Japanese outpatients diagnosed with MDD were assessed on severity of depressive symptoms, cognitive function, social and work function, and quality of life (QoL) over 6 months following initiation of antidepressant therapy. This post hoc analysis evaluated the internal consistency and convergent validity of the PDQ-D-5 in relation to the original PDQ-D-20. Correlations of scores on these measures were examined at each time point and over time. The same set of analyses was explored between PDQ-D-5 and the Patient Health Questionnaire-nine-item (PHQ-9), Montgomery-Asberg Depression Rating Scale (MADRS), Digit Symbol Substitution Test (DSST), five-level version of EQ-5D (EQ-5D-5L), Sheehan Disability Scale (SDS), and Work Productivity and Activity Impairment (WPAI) questionnaire. Results PDQ-D-5 scores showed good internal consistency. Strong positive correlations were observed between PDQ-D-5 and PDQ-D-20 at each time point (correlation coefficient: baseline, 0.94; month 1, 0.94; month 2, 0.96; month 6, 0.96) and over time (0.92) (all p < 0.0001). Longitudinally, there were positive correlations between PDQ-D-5 scores versus those on the PHQ-9, MADRS, and SDS. Similarly, negative correlations were noted between PDQ-D-5 scores and EQ-5D-5L and DSST scores to a variable degree. There were moderate positive correlations over time between PDQ-D-5 and all WPAI subscale scores except those on absenteeism. Conclusion PDQ-D-5 scores rated in Japanese patients with MDD were found to adequately represent scores on the PDQ-D-20. The short version also showed associations with several measures of functional outcome, depression severity and QoL. This validates the PDQ-D-5 as a feasible and clinically reliable tool to assess subjective experience on cognition, which is applicable to time-limited consultations. UMIN Clinical Trials Registry for Primary Study UMIN000024320.
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Affiliation(s)
- Tomiki Sumiyoshi
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Hiroyuki Uchida
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Koichiro Watanabe
- Department of Neuropsychiatry, Kyorin University School of Medicine, Tokyo, Japan
| | - Masato Oosawa
- Japan Medical Office, Takeda Pharmaceutical Company Limited, Osaka, Japan
| | - Hongye Ren
- Medical Affairs, H. Lundbeck A/S, Copenhagen, Denmark
| | | | - Keita Fujikawa
- Japan Medical Office, Takeda Pharmaceutical Company Limited, Osaka, Japan
| | - Jovelle Fernandez
- Japan Medical Office, Takeda Pharmaceutical Company Limited, Osaka, Japan
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Association between baseline cognitive symptoms and the subsequent presenteeism and global function in patients with major depressive disorder. J Psychiatr Res 2022; 154:324-331. [PMID: 36027860 DOI: 10.1016/j.jpsychires.2022.07.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 07/07/2022] [Accepted: 07/20/2022] [Indexed: 11/21/2022]
Abstract
Cognitive symptoms in major depressive disorder (MDD) contribute to impaired functional abilities and work productivity, particularly presenteeism. We investigated the association between baseline cognitive symptoms and subsequent presenteeism, and global functional impairment in Japanese patients with MDD from PERFORM-J (Prospective Epidemiological Research on Functioning Outcomes Related to Major Depressive Disorder in Japan) - a 6-month, multicenter, epidemiological study data. A total of 518 patients initiating antidepressant monotherapy (first-line or switched from another drug) were enrolled. Assessments include Perceived Deficits Questionnaire - Depression (PDQ-D) for cognitive complaints, Sheehan Disability Scale (SDS) for global function (analysed n = 318), and Work Productivity and Activity Impairment Questionnaire for presenteeism (analysed n = 122). A strong association between changes in presenteeism and changes in SDS scores (r: total = 0.636; work/school = 0.686) was observed. After adjusting for sociodemographic and MDD-related factors, patients without cognitive complaints at baseline showed lower odds of impaired presenteeism at 6 months versus patients with cognitive complaints (0.243, 95% CI: 0.079 to 0.747, p = 0.014) and also in patients with first episode of MDD against with recurrent MDD (0.327 (95% CI: 0.136 to 0.787). Similarly, patients without cognitive complaints had healthier global functioning (lower mean SDS total score) than patients with cognitive complaints (8.3 vs 11.2; 95% CI, -5.189 to -0.578; p = 0.014). First depressive episode (lower risk of presenteeism), being male, and low baseline SDS total score (better global functioning) were also associated with improved outcomes. These results highlight the potential value of baseline PDQ-D scores in predicting subsequent workplace and global functioning in patients undergoing treatment for MDD.
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Humanistic and economic burden associated with depression in the United States: a cross-sectional survey analysis. BMC Psychiatry 2022; 22:542. [PMID: 35953786 PMCID: PMC9367058 DOI: 10.1186/s12888-022-04165-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 07/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Depression (major depressive disorder [MDD]) affects the functioning of patients in many facets of life. Very few large-scale studies to date have compared health and economic related outcomes of those with versus without depression, and across various depression severity groups. We aimed to evaluate humanistic and economic burden in respondents with and without depression diagnosis, and across symptom severity groups. METHODS Data from the 2017 US National Health and Wellness Survey (NHWS) were utilized. Of the adult respondents (N = 75,004), 59,786 were < 65 years old. Respondents not meeting eligibility criteria were excluded (e.g., those self-reporting bipolar disorder or experiencing depression in past 12 months but no depression diagnosis). Overall, data from 39,331 eligible respondents (aged 18-64 years) were analyzed; and comprised respondents 'with depression diagnosis' (n = 8853; self-reporting physician diagnosis of depression and experiencing depression in past 12 months) and respondents 'without depression diagnosis' (n = 30,478; no self-reported physician diagnosis of depression and not experiencing depression). Respondents with depression were further examined across depression severity based on Patient Health Questionnaire-9 (PHQ-9). Outcome measures included health-related quality-of-life (HRQoL; Medical Outcomes Study 36-item Short Form [SF-36v2]: mental and physical component summary [MCS and PCS]; Short-Form 6 Dimensions [SF-6D]; and EuroQol 5 Dimensions [EQ-5D]), work productivity and activity impairment (WPAI), and health resource utilization (HRU). Multivariate analysis was performed to examine group differences after adjusting covariates. RESULTS Respondents with depression diagnosis reported significantly higher rates of diagnosed anxiety and sleep problems versus those without depression (for both; P < 0.001). Adjusted MCS, PCS, SF-6D, and EQ-5D scores were significantly lower in respondents with depression versus those without depression (all P < 0.001). Consistently, respondents with depression reported higher absenteeism, presenteeism, and overall WPAI, as well as greater number of provider visits, emergency room visits, and hospitalizations compared with those without depression (all P < 0.001). Further, burden of each outcome increased with an increase in disease severity. CONCLUSIONS Diagnosed depression was associated with lower health-related quality-of-life and work productivity, and higher healthcare utilization than those without depression, and burden increased with an increase in symptom severity. The results show the burden of depression remains high even among those experiencing minimal symptoms.
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Shi X, He X, Pan D, Qiao H, Li J. Happiness, depression, physical activity and cognition among the middle and old-aged population in China: a conditional process analysis. PeerJ 2022; 10:e13673. [PMID: 35782096 PMCID: PMC9248807 DOI: 10.7717/peerj.13673] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 06/13/2022] [Indexed: 01/17/2023] Open
Abstract
Background Happiness is one variable of subjective well-being, which has been increasingly shown to have protective effects on health. Although the association between happiness and cognition has been established, the mechanism by which happiness leads to cognition remains unclear. Since happiness, depression, and physical activity may all be related to cognition, and happiness is related to depression and physical activity, this study explored the effect of depression and physical activity on the relationship between happiness and cognition among middle and old-aged individuals in China. Methods Data on 14,344 participants above 45 years of age were obtained from the 2018 China Family Panel Studies survey. A multiple linear regression analysis was performed to identify the correlation factors of cognition. The conditional process analysis was used to assess the mediatory effect of depression and physical activity on the relationship between happiness and cognition. Results Residence, age, sex, income level, social status, smoking, napping, reading, education, exercise times, satisfaction, happiness, and depression had associations with cognition. When other variables were held constant, cognition score increased by 0.029 standard deviation(SD) for every 1 SD increased in happiness. Mediation analysis showed that happiness had a significant positive total effect on cognition. The direct effect of happiness was significant and accounted for 57.86% of the total effect. The mediatory effect of depression (path of happiness→depression→cognition) accounted for 38.31% of the total effect, whereas that of physical activity (path of happiness→exercise times→cognition) accounted for 3.02% of the total effect. Conclusion Happiness has a positive correlation with cognitive function, and depression and physical activity play mediatory roles in this association. Effective interventions to improve happiness levels of middle and old-aged population will not only improve their subjective well-being but also improve their cognitive function, which carries great potential for reducing public health burdens related to cognitive aging.
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Affiliation(s)
- Xiaojuan Shi
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, China
| | - Xiaoxue He
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, China
| | - Degong Pan
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, China
| | - Hui Qiao
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, China
| | - Jiangping Li
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, China,Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, China
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Minley K, Smith CA, Batioja K, Andriana Peña BS, Shepard S, Heigle B, Kee M, Wise A, Hillman C, Ottwell R, Hartwell M, Vassar M. The evaluation of reporting of patient-reported outcomes in MDD: A meta-epidemiological study of clinical trials. J Psychiatr Res 2022; 150:79-86. [PMID: 35358835 DOI: 10.1016/j.jpsychires.2022.03.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 01/26/2022] [Accepted: 03/21/2022] [Indexed: 11/25/2022]
Abstract
Major depressive disorder (MDD) is a multifaceted disease that profoundly affects quality of life. Patient reported outcomes (PROs) are used in randomized controlled trials (RCTs) to better understand patient perspectives on interventions. Therefore, we sought to assess the completeness of reporting PROs in RCTs addressing MDD. We identified RCTs evaluating MDD containing a PRO measure published between 2016 and 2020 from MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials. Inclusion of studies was performed in duplicate. The completion of reporting of RCTs was assessed using the Consolidated Standards of Reporting Trials (CONSORT-PRO) adaptation. Bivariate regression analyses were used to evaluate reporting completeness and trial characteristics. A total of 49 RCTs were included in our analysis, with a mean CONSORT-PRO completion score of 56.7% (SD = 17.3).Our findings show a significant association with completeness of reporting and the following: secondary PRO trials were less completely reported as compared to primary PRO trials (t = -3.19, p = .003); studies with a follow-up period between six months and year were more completely reported as compared to three months or less (6 months to a year, t = 2.34, p = .024); and increased trial sample size was associated with more completeness of reporting (t = 3.17, p = .003). As compared to brain stimulation, the intervention types classified as combination, other, and psychotherapy had greater completeness of reporting (combination, t = 2.35, p = .024; other, t = 3.13, p = .003; psychotherapy, t = 3.41, p = .001). There were no other significant findings. Our study found the completeness of PRO reporting to be inconsistent in RCTs regarding MDD. Moreover, we advocate for the need to establish a core outcome set relevant to the management of adults diagnosed with MDD and facilitate training on the application of PRO data.
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Affiliation(s)
- Kirstien Minley
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA.
| | - Caleb A Smith
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Kelsi Batioja
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - B S Andriana Peña
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Samuel Shepard
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Benjamin Heigle
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Micah Kee
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Audrey Wise
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Cody Hillman
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Ryan Ottwell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA; Department of Internal Medicine, University of Oklahoma, School of Community Medicine, Tulsa, OK, USA
| | - Micah Hartwell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA; Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Matt Vassar
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA; Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
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10
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Chow TK, Bowie CR, Morton M, Lalovic A, McInerney SJ, Rizvi SJ. Contributors of Functional Impairment in Major Depressive Disorder: a Biopsychosocial Approach. Curr Behav Neurosci Rep 2022. [DOI: 10.1007/s40473-022-00247-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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11
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Noto S, Wake M, Mishiro I, Hammer-Helmich L, Ren H, Moriguchi Y, Fujikawa K, Fernandez J. Health-Related Quality of Life Over 6 Months in Patients With Major Depressive Disorder Who Started Antidepressant Monotherapy. Value Health Reg Issues 2022; 30:127-133. [PMID: 35405582 DOI: 10.1016/j.vhri.2021.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 11/03/2021] [Accepted: 12/30/2021] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Major depressive disorder (MDD) is increasing worldwide and is associated with impaired quality of life (QOL). This study aimed to assess the QOL and its association with cognitive symptoms in patients with MDD who started antidepressant monotherapy. METHODS Data from the PERFORM (Prospective Epidemiological Research on Functioning Outcomes Related to Major Depressive Disorder) study were analyzed. A descriptive epidemiological analysis on EQ-5D-5L utility score, the level of each dimension, and the EuroQoL visual analog scale value was conducted at 4 visits during 6 months' follow-up. The association between cognitive complaints and changes in QOL measures was analyzed using multivariate linear regression analysis. RESULTS The median EQ-5D-5L utility score improved from 0.67 at baseline to 0.82 at month 6. Although the proportion of patients reporting level 1 (no problem) in every dimension of mobility, self-care, usual activities, pain/discomfort, and anxiety/depression increased over time, less than half of the patients achieved level 1 in pain/discomfort and depression/anxiety, which were closely related to depression and usual activities at month 6. Patients with no cognitive complaints or no history of MDD at baseline showed greater improvement in EQ-5D-5L utility scores and EuroQoL visual analog scale value for measuring QOL than those with these characteristics. CONCLUSIONS Treatment over 6 months improved QOL in patients with MDD although there remained room for improvement in dimensions of usual activities, pain/discomfort, and depression/anxiety. Cognitive complaints or history of MDD at baseline predicted less improvement in QOL at 6 months. Any history of MDD might delay improvement in QOL after treatment.
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Affiliation(s)
- Shinichi Noto
- Department of Rehabilitation, Niigata University of Health and Welfare, Niigata, Japan.
| | - Mayumi Wake
- Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan
| | - Izumi Mishiro
- Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan
| | | | | | | | - Keita Fujikawa
- Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan
| | - Jovelle Fernandez
- Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan
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12
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Widyowati A, Murti B, Sudiyanto A. Relationship of Ability of Family Caregivers and Society’s Stigma to Prevent Relapse and Improve the Quality of Life for People with Mental Disorders. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.7033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
People with mental disorders will experience a relapse even after 1 month of getting treatment or care from a health facility. The high recurrence rate can cause a decrease in quality of life. Efforts to prevent recurrence by involving family caregivers and reducing stigma from the community. This study aims to analyze the relationship between the ability of family caregivers and community stigma to prevent recurrence and improve the quality of life of people with mental disorders. This study used a cross-sectional approach. The research location is in Kediri Regency, East Java, Indonesia. Sampling was done by using the multistage random sampling technique. The number of samples is 76 respondents. The variables in this study were the ability of family caregivers, community stigma, disease recurrence, and quality of life for people with mental disorders. The data were analyzed using path analysis with the help of STATA 13. There is a relationship between the ability of family caregivers and community stigma to prevent recurrence and improve the quality of life of people with mental disorders.
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13
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Ingulfsvann Hagen B, Landrø NI, Hoorelbeke K, Lau B, Stubberud J. Characteristics associated with the discrepancy between subjective and objective executive functioning in depression. APPLIED NEUROPSYCHOLOGY-ADULT 2021:1-10. [PMID: 34523373 DOI: 10.1080/23279095.2021.1969398] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Major depressive disorder (MDD) is associated with both self-reported (subjective) cognitive complaints and deficits in neurocognitive (objective) measures, but the correspondence between subjective and objective measures of cognition is low. This cross-sectional study aimed to (1) assess the association between subjective and objective measures of executive functions (EFs), and (2) explore factors associated with the discrepancy between subjective and objective EFs in MDD. Sixty-two participants with current or previous mild to moderate MDD and subjective EF complaints completed a clinical trial baseline assessment. An objective EF composite score was drawn from six neurocognitive measures, while the Behavior Rating Inventory of Executive Function-Adult version was applied as a measure of subjective EF. The association between the subjective and objective composites was evaluated using Spearman's rank order correlation. A discrepancy score was calculated to quantify the difference between subjective and objective EF. Factors associated with the discrepancy score were analyzed using regression analysis (p < .05). Participants reported extensive EF difficulties, but most performed in the normal range on objective EF measures. A weak correlation was detected between the subjective and objective measures (rs = .015). More rumination (β = -.364) and higher IQ (β = -.420) were associated with reporting more subjective complaints than was evident from objective measures of EF (i.e., underestimation). Subjective and objective EF measures are weakly overlapping in MDD. Findings underscore recommendations to include both subjective and objective measures when assessing EFs in depression. In addition, findings suggest that targeting ruminative processes could help correct underestimation.
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Affiliation(s)
- Bjørn Ingulfsvann Hagen
- Department of Research, Lovisenberg Diaconal Hospital, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | | | - Kristof Hoorelbeke
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Bjørn Lau
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Jan Stubberud
- Department of Research, Lovisenberg Diaconal Hospital, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
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14
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Schüssler-Fiorenza Rose SM, Bott NT, Heinemeyer EE, Hantke NC, Gould CE, Hirst RB, Jordan JT, Beaudreau SA, O'Hara R. Depression, health comorbidities, cognitive symptoms and their functional impact: Not just a geriatric problem. J Psychiatr Res 2021; 139:185-192. [PMID: 34087515 PMCID: PMC8253546 DOI: 10.1016/j.jpsychires.2021.05.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 04/16/2021] [Accepted: 05/01/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To compare the prevalence of cognitive symptoms and their functional impact by age group accounting for depression and number of other health conditions. METHODS We analyzed data from the 2011 Behavioral Risk Factor Surveillance System, a population-based, cross-sectional telephone survey of US adults. Twenty-one US states asked participants (n = 131, 273) about cognitive symptoms (worsening confusion or memory loss in the past year) and their functional impact (interference with activities and need for assistance). We analyzed the association between age, depression history and cognitive symptoms and their functional impact using logistic regression and adjusted for demographic characteristics and other health condition count. RESULTS There was a significant interaction between age and depression (p < 0.0001). In adults reporting depression, the adjusted odds of cognitive symptoms in younger age groups (<75 years) were comparable or greater to those in the oldest age group (≥75 years) with a peak in the middle age (45-54 years) group (OR 1.9 (95% Confidence Interval: 1.4-2.5). In adults without depression, adults <75 years had a significantly lower adjusted odds of cognitive symptoms compared to the oldest age group with the exception of the middle-aged group where the difference was not statistically significant. Over half of adults under age 65 with depression reported that cognitive symptoms interfered with life activities compared to 35.7% of adults ≥65 years. CONCLUSIONS Cognitive symptoms are not universally higher in older adults; middle-aged adults are also particularly vulnerable. Given the adverse functional impact associated with cognitive symptoms in younger adults, clinicians should assess cognitive symptoms and their functional impact in adults of all ages and consider treatments that impact both cognition and functional domains.
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Affiliation(s)
| | - Nicholas T Bott
- Clinical Excellence Research Center, Stanford University School of Medicine, 365 Lasuen St, Stanford, CA, 94305, USA
| | - Erin E Heinemeyer
- PGSP-Stanford PsyD Consortium, Palo Alto University, 1791 Arastradero Rd, Palo Alto, CA, 94304, USA
| | - Nathan C Hantke
- Sierra Pacific Mental Illness Research Education and Clinical Centers (MIRECC), Veterans Affairs Palo Alto Health Care System, 3801 Miranda Ave, Palo Alto, CA, 94304, USA; Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA
| | - Christine E Gould
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Rd, Stanford, CA, 94305, USA; Geriatric Research Education and Clinical Center (GRECC), Veterans Affairs Palo Alto Health Care System, 3801 Miranda Ave, Palo Alto, CA, 94304, USA
| | - Rayna B Hirst
- School of Psychology, Palo Alto University, 1791 Arastradero Road, Palo Alto, CA, 94304, USA
| | - Joshua T Jordan
- Department of Psychology, Domincan University of California, 50 Acacia Avenue, San Rafael, CA, 94901, USA
| | - Sherry A Beaudreau
- Sierra Pacific Mental Illness Research Education and Clinical Centers (MIRECC), Veterans Affairs Palo Alto Health Care System, 3801 Miranda Ave, Palo Alto, CA, 94304, USA; Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Rd, Stanford, CA, 94305, USA; School of Psychology, University of Queensland, Brisbane, QLD, 4072, Australia
| | - Ruth O'Hara
- Sierra Pacific Mental Illness Research Education and Clinical Centers (MIRECC), Veterans Affairs Palo Alto Health Care System, 3801 Miranda Ave, Palo Alto, CA, 94304, USA; Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Rd, Stanford, CA, 94305, USA; School of Psychology, University of Queensland, Brisbane, QLD, 4072, Australia
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15
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Brockbank J, Krause T, Moss E, Pedersen AM, Mørup MF, Ahdesmäki O, Vaughan J, Brodtkorb TH. Health state utility values in major depressive disorder treated with pharmacological interventions: a systematic literature review. Health Qual Life Outcomes 2021; 19:94. [PMID: 33736649 PMCID: PMC7977292 DOI: 10.1186/s12955-021-01723-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 02/25/2021] [Indexed: 11/30/2022] Open
Abstract
Background Major depressive disorder (MDD) is associated with decreased patient well-being and symptoms that can cause substantial impairments in patient functioning and even lead to suicide. Worldwide, MDD currently causes the second-most years lived with disability and is predicted to become the leading cause of disability by 2030. Utility values, capturing patient quality of life, are required in economic evaluations for new treatments undergoing reimbursement submissions. We aimed to identify health state utility values (HSUVs) and disutilities in MDD for use in future economic evaluations of pharmacological treatments. Methods Embase, PubMed, Econlit, and Cochrane databases, plus gray literature, were searched from January 1998 to December 21, 2018, with no language or geographical restrictions, for relevant studies that reported HSUVs and disutilities for patients with MDD receiving pharmacological interventions. Results 443 studies were identified; 79 met the inclusion criteria. We focused on a subgroup of 28 articles that reported primary utility data from 16 unique studies of MDD treated with pharmacological interventions. HSUVs were elicited using EQ-5D (13/16, 81%; EQ-5D-3L: 11/16, 69%; EQ-5D-3L or EQ-5D-5L not specified: 2/16), EQ-VAS (5/16, 31%), and standard gamble (1/16, 6%). Most studies reported baseline HSUVs defined by study entry criteria. HSUVs for a first or recurrent major depressive episode (MDE) ranged from 0.33 to 0.544 and expanded from 0.2 to 0.61 for patients with and without painful physical symptoms, respectively. HSUVs for an MDE with inadequate treatment response ranged from 0.337 to 0.449. Three studies reported HSUVs defined by MADRS or HAMD-17 clinical thresholds. There was a large amount of heterogeneity in patient characteristics between the studies. One study reported disutility estimates associated with treatment side effects. Conclusions Published HSUVs in MDD, elicited using methods accepted by health technology assessment bodies, are available for future economic evaluations. However, the evidence base is limited, and it is important to select appropriate HSUVs for the intervention being evaluated and that align with clinical health state definitions used within an economic model. Future studies are recommended to elicit HSUVs for new treatments and their side effects and add to the existing evidence where data are lacking. Supplementary Information The online version contains supplementary material available at 10.1186/s12955-021-01723-x.
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16
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Han H, Hou Y, Yao S, Hu S, Zhou Q, Yu X, McIntyre RS, Shi C. The Relationship Between Cognitive Dysfunction Through THINC-Integrated Tool (THINC-it) and Psychosocial Function in Chinese Patients With Major Depressive Disorder. Front Psychiatry 2021; 12:763603. [PMID: 34887790 PMCID: PMC8650222 DOI: 10.3389/fpsyt.2021.763603] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 10/18/2021] [Indexed: 12/05/2022] Open
Abstract
Background: Herein, we validate the psychometric properties of the Chinese version of the THINC-integrated tool (THINC-it) as a screening tool for cognitive deficits in patients with major depressive disorder. The primary aim of this study is to determine whether cognitive deficits as detected by the THINC-it tool in adults with major depressive disorder (MDD) are associated with workplace productivity and/or psychosocial function. Methods: Subjects aged 18-65 (n = 91) with MDD were evaluated and compared to age-, sex- and education- matched healthy controls (n = 95). Symptoms of cognitive dysfunction, workplace productivity, and psychosocial function were measured using the THINC-it tool, Hamilton Depression Scale (HAMD), Sheehan Disability Scale (SDS), The Work Productivity and Activity Impairment questionnaire- Specific Health Problem (WPAI-SHP). Results: There were significant differences in THINC-it scores (p < 0.01), the average of HAMD total score (p < 0.01) and all aspects of SDS (p < 0.01) between two groups. There were significant differences in the four aspects of WPAI between the two groups in the employed status (p <0.01). THINC-it subjective cognition and SDS total score, SDS work/school, SDS social, SDS family showed significantly correlation (r ranging from 0.255 to 0.386, p <0.01). SDS and THINC-it Objective cognition, THINC-it comprehensive cognition were no correlation between two groups. HAMD total score and SDS total score, SDS social, SDS family showed significantly correlation (r ranging.
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Affiliation(s)
- Han Han
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, China.,Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China.,National Health Commission (NHC) Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Health Disorders (Peking University Sixth Hospital), Beijing, China
| | - Yanyan Hou
- Qingdao Mental Health Center, Qingdao University, Shandong, China
| | - Shuqiao Yao
- Medical Psychological Center, The Second Xiangya Hospital Central South University, Changsha, China
| | - Shaohua Hu
- Department of Psychiatry, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.,The Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, China
| | - Qi Zhou
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China.,National Health Commission (NHC) Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Health Disorders (Peking University Sixth Hospital), Beijing, China
| | - Xin Yu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China.,National Health Commission (NHC) Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Health Disorders (Peking University Sixth Hospital), Beijing, China
| | - Roger S McIntyre
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Mood Disorders Psychopharmacology Unit, Brain and Cognition Discovery Foundation (BCDF), Toronto, ON, Canada.,Depression and Bipolar Support Alliance (DBSA), Chicago, IL, United States.,Academician workstation of Mood and Brain Sciences, Guangzhou Medical University, Guangzhou, China.,College of Medicine, Korea University, Seoul, South Korea.,Department of Psychiatry and Neuroscience, School of Medicine, University of California, Riverside, Riverside, CA, United States
| | - Chuan Shi
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China.,National Health Commission (NHC) Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Health Disorders (Peking University Sixth Hospital), Beijing, China
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17
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Sumiyoshi T, Watanabe K, Noto S, Sakamoto S, Moriguchi Y, Hammer-Helmich L, Fernandez J. Relationship of Subjective Cognitive Impairment with Psychosocial Function and Relapse of Depressive Symptoms in Patients with Major Depressive Disorder: Analysis of Longitudinal Data from PERFORM-J. Neuropsychiatr Dis Treat 2021; 17:945-955. [PMID: 33814911 PMCID: PMC8009536 DOI: 10.2147/ndt.s288108] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 02/11/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Accumulating evidence suggests the presence of cognitive impairment in patients with major depressive disorder (MDD), which affects their psychosocial function and quality of life (QoL). PERFORM-J (Prospective Epidemiological Research on Functioning Outcomes Related to MDD in Japan) is an observational, multicenter study to assess longitudinal changes in depressive symptoms, psychomotor speed, subjective cognitive function, and psychosocial function. METHODS Five hundred and eighteen Japanese outpatients with MDD initiating new antidepressant monotherapy (first-line or switch from previous drug) as part of their routine medical care participated in this study. Assessments at baseline and over the 6-month observation period included physician-rated depression severity (Montgomery-Åsberg Depression Rating Scale), psychomotor speed (Digit Symbol Substitution Test; DSST), subjective cognition (Perceived Deficits Questionnaire-Depression), psychosocial function (Sheehan Disability Scale), and QoL (EuroQol-5 Dimension-5 Level). RESULTS Antidepressant treatment for 6 months improved depressive symptoms and subjective cognitive impairment (cognitive complaints), whereas psychomotor speed remained impaired (ie, DSST total score was >1 standard deviation below the norm) in 35.6% of patients at 6 months. Impairment of subjective cognition, but not psychomotor speed at month 2 was associated with poor psychosocial function and QoL at 6 months. There was a trend for higher relapse rates at 6 months in patients with greater subjective cognitive impairment at 2 months. CONCLUSION These findings highlight the importance of evaluating cognitive difficulties to predict long-term outcomes in patients with MDD. Early intervention for cognitive complaints may decrease the relapse rate, which warrants further study.
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Affiliation(s)
- Tomiki Sumiyoshi
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Koichiro Watanabe
- Department of Neuropsychiatry, Kyorin University School of Medicine, Tokyo, Japan
| | - Shinichi Noto
- Faculty of Rehabilitation, Niigata University of Health and Welfare, Niigata, Japan
| | - Shigeru Sakamoto
- Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan
| | | | | | - Jovelle Fernandez
- Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan
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18
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Toyoshima K, Inoue T, Shimura A, Masuya J, Ichiki M, Fujimura Y, Kusumi I. Associations between the depressive symptoms, subjective cognitive function, and presenteeism of Japanese adult workers: a cross-sectional survey study. Biopsychosoc Med 2020; 14:10. [PMID: 32391075 PMCID: PMC7197112 DOI: 10.1186/s13030-020-00183-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 04/08/2020] [Indexed: 12/04/2022] Open
Abstract
Background Presenteeism has attracted much attention in the research into mental health. However, how cognitive complaints and depressive symptoms affect presenteeism remains unknown. Therefore, this study examined the correlation between subjective cognitive impairment, depressive symptoms, and work limitations. Methods We collected data from 477 adult workers in Japan. We evaluated subjective cognitive function using the Cognitive Complaints in Bipolar Disorder Rating Assessment (COBRA), depressive symptoms with the Patient Health Questionnaire 9 (PHQ-9), and work limitations with the Work Limitations Questionnaire 8 (WLQ-8). The relations between depressive symptoms, cognitive complaints, and work limitations were examined using Spearman’s rank correlations and multiple regression analysis. It was hypothesized that cognitive complaints would mediate the effects of depressive symptoms on work productivity loss, which was tested using path analysis. Results The results indicated that cognitive complaints were significantly correlated with work limitations and depressive symptoms. Multiple regression analysis, using the WLQ-8 productivity loss score as the dependent variable, revealed that COBRA and PHQ-9 scores were significant predictors of work productivity loss. We performed path analysis using PHQ-9, COBRA, and WLQ-8 productivity loss scores and created a path diagram, which revealed that the direct effects of both depressive symptoms and cognitive dysfunction on work productivity loss were statistically significant. Moreover, depressive symptoms indirectly affected work productivity loss through subjective cognitive impairment. There was no significant interaction effect between depressive symptoms and cognitive complaints. Conclusions Our results suggest that work limitations may be predicted by not only depressive symptoms but also cognitive complaints. Moreover, subjective cognitive impairment may mediate the effect of depressive symptoms on presenteeism among adult workers.
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Affiliation(s)
- Kuniyoshi Toyoshima
- 1Department of Psychiatry, Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Sapporo, 060-8638 Japan
| | - Takeshi Inoue
- 2Department of Psychiatry, Tokyo Medical University, Shinjuku-ku, Tokyo, 160-0023 Japan
| | - Akiyoshi Shimura
- 2Department of Psychiatry, Tokyo Medical University, Shinjuku-ku, Tokyo, 160-0023 Japan
| | - Jiro Masuya
- 2Department of Psychiatry, Tokyo Medical University, Shinjuku-ku, Tokyo, 160-0023 Japan
| | - Masahiko Ichiki
- 2Department of Psychiatry, Tokyo Medical University, Shinjuku-ku, Tokyo, 160-0023 Japan
| | - Yota Fujimura
- 2Department of Psychiatry, Tokyo Medical University, Shinjuku-ku, Tokyo, 160-0023 Japan
| | - Ichiro Kusumi
- 1Department of Psychiatry, Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Sapporo, 060-8638 Japan
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19
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The association of cognitive deficits with mental and physical Quality of Life in Major Depressive Disorder. Compr Psychiatry 2020; 97:152147. [PMID: 31838296 DOI: 10.1016/j.comppsych.2019.152147] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 11/09/2019] [Accepted: 11/10/2019] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Patients with Major Depressive Disorder experience significantly reduced subjective Quality of Life (QOL), including impaired social and emotional functioning and greater fatigue and physical pain. Mounting evidence suggests that cognitive dysfunction (e.g., deficits in memory, executive function) contributes independently to the onset of reduced QOL, however the domain-specific nature of this relationship has not been investigated. The present study examined the relationship between specific cognitive domains (e.g., attention, spatial cognition) and specific deficits in mental and physical QOL in subjects with lifetime MDD, as well as acutely depressed, remitted and healthy participants. METHODS Data were obtained (N = 387) from the Cognitive Function and Mood Study (COFAMS), a cross-sectional study of emotional, functional and cognitive status in individuals with mood disorders. Participants' (acutely depressed n = 93, remitted n = 170, and healthy control n = 124) QOL was assessed with the 36-Item Short Form Health Survey (SF-36) and cognitive functioning was evaluated with the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), the Colorado Assessment Tests (CATs) and the Psychology Experiment Building Language (PEBL). RESULTS Analyses revealed that poor immediate and delayed memory were associated with reduced mental QOL in individuals with lifetime MDD, acutely depressed, and healthy controls. In contrast, cognitive functioning was not associated with mental QOL in remitted patients. No cognitive domains were significantly related to physical QOL in any participant group. CONCLUSIONS The result suggests that deficits in immediate and delayed memory may contribute to reduced mental QOL in acute MDD, whereas cognition does not appear to play a role in physical QOL. Memory should be considered important cognitive treatment targets for MDD patients suffering specifically from reduced mental QOL.
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20
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Improvements in Workplace Productivity in Working Patients With Major Depressive Disorder: Results From the AtWoRC Study. J Occup Environ Med 2020; 62:e94-e101. [PMID: 31895735 DOI: 10.1097/jom.0000000000001805] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To assess changes in workplace productivity and functioning in an open-label study in working patients receiving vortioxetine (10 to 20 mg/d) for major depressive disorder (MDD). METHODS Associations between items in the Work Limitations Questionnaire (WLQ), the Sheehan Disability Scale (SDS), and the Work Productivity and Activity Impairment (WPAI) questionnaire were assessed at 12 and 52 weeks by Pearson correlation coefficients. RESULTS Significant improvements were observed across all domains of workplace productivity and functioning after 12 and 52 weeks' vortioxetine treatment. Strong correlations were seen between improvements in WLQ mental domains and WPAI presenteeism and SDS work/school items. Presenteeism showed stronger correlations with other workplace productivity measures than absenteeism. CONCLUSIONS Presenteeism and absenteeism impact productivity in working patients with MDD. Vortioxetine confers long-term benefits across all workplace functioning domains.
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21
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Wang G, Tan KHX, Ren H, Hammer-Helmich L. Impact of Cognitive Symptoms on Health-Related Quality of Life and Work Productivity in Chinese Patients with Major Depressive Disorder: Results from the PROACT Study. Neuropsychiatr Dis Treat 2020; 16:749-759. [PMID: 32214816 PMCID: PMC7081063 DOI: 10.2147/ndt.s230403] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 02/15/2020] [Indexed: 01/10/2023] Open
Abstract
PURPOSE This post hoc analysis was undertaken to further explore the association of cognitive symptoms with health-related quality of life (HRQoL) and work productivity at the time of treatment initiation in Chinese patients with major depressive disorder (MDD) in the Prospective Research Observation to Assess Cognition in Treated patients with MDD (PROACT) study. PATIENTS AND METHODS This was an epidemiological, non-interventional, prospective cohort study in adult outpatients with moderate-to-severe MDD initiating antidepressant monotherapy (first or second line). Crude and adjusted analyses of covariance were performed to assess the association of perceived cognitive symptoms (20-item Perceived Deficits Questionnaire-Depression [PDQ-D] total score) or observed cognitive performance (Digit Symbol Substitution Test [DSST] score) with HRQoL (EuroQoL 5-Dimensions Questionnaire index) and work productivity (Work Productivity and Activity Impairment [WPAI] or Sheehan Disability Scale [SDS] absenteeism and presenteeism scores). Adjusted analyses included depression severity, age, sex, residential area (urban/rural), and educational level. RESULTS Of 1008 patients enrolled in the PROACT study, 986 were included in this analysis. Severity of perceived cognitive symptoms (ie, higher PDQ-D total score) was significantly associated with worse HRQoL (P<0.001) and higher levels of absenteeism (P=0.020 for the WPAI and P=0.002 for the SDS) and presenteeism (P<0.001 for both scales). The association of perceived cognitive symptoms with HRQoL and presenteeism was independent of depression severity. The association between observed cognitive performance (DSST score) and HRQoL was less robust. No association was seen between observed cognitive performance and levels of absenteeism or presenteeism assessed by either scale. CONCLUSION Results of this real-world study illustrate the impact of cognitive symptoms on HRQoL and work productivity in Chinese patients with MDD, and highlight the importance of assessing and targeting cognitive symptoms in order to improve functional outcomes when treating patients with MDD.
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Affiliation(s)
- Gang Wang
- Psychiatry Department, Beijing an Ding Hospital, Capital Medical University, China National Clinical Research Center for Mental Disorders, Beijing, People's Republic of China
| | - Kristin Hui Xian Tan
- Health Economics & Epidemiology Statistics, Lundbeck Singapore Pte Ltd, Singapore
| | - Hongye Ren
- Medical Affairs Value Evidence, H. Lundbeck A/S, Valby, Denmark
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Happiness and Cognitive Impairment Among Older Adults: Investigating the Mediational Roles of Disability, Depression, Social Contact Frequency, and Loneliness. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16244954. [PMID: 31817633 PMCID: PMC6950127 DOI: 10.3390/ijerph16244954] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 11/21/2019] [Accepted: 11/29/2019] [Indexed: 12/20/2022]
Abstract
Background: Understanding the lower level of happiness among older adults with cognitive impairment has been a largely neglected issue. This study (1) reports on the level of happiness among older adults in Singapore and (2) examines the potential mediating roles of depression, disability, social contact frequency, and loneliness in the relationship between cognitive scores and happiness. Methods: Data for this study were extracted from the Well-being of the Singapore Elderly (WiSE) study: a cross-sectional; comprehensive single-phase survey conducted among Singapore citizens and permanent residents that were aged 60 years and above (n = 2565). The Geriatric Mental State examination (GMS) was administered to the participants. Questions pertaining to socio-demographic characteristics; happiness; loneliness; social contact; depression; and, disability were utilized in this study. Logistic regression analyses and mediation analyses were used to explore the correlates of happiness and potential mediating factors. Results: Overall, 96.2% of older adults in Singapore reported feeling either fairly happy or very happy. In the regression analysis, individuals of Malay descent, those who were married/cohabiting, or had higher education levels were more likely to report feeling happy. After controlling for socio-demographic factors, higher cognitive scores were associated with higher odds of reporting happiness. We found that the positive association between cognition and happiness was fully mediated by disability, depression, loneliness, and frequency of contact with friends. Conclusion: The majority of the older adult population reported feeling fairly or very happy. While cognitive impairment has shown limited reversibility in past studies, unhappiness among older adults with cognitive impairment might be potentially mitigated through interventions addressing accompanying issues of social isolation, disability, and depression
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Long-term functioning outcomes are predicted by cognitive symptoms in working patients with major depressive disorder treated with vortioxetine: results from the AtWoRC study. CNS Spectr 2019; 24:616-627. [PMID: 30802419 DOI: 10.1017/s1092852919000786] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE AtWoRC (Assessment in Work productivity and the Relationship with Cognitive symptoms) was an interventional, open-label, Canadian study (NCT02332954) designed to assess the association between cognitive symptoms and workplace productivity in working patients with major depressive disorder (MDD) receiving vortioxetine. METHODS Eligible patients with MDD received vortioxetine (10-20 mg/day) and were assessed over 52 weeks at visits emulating a real-life setting (n = 199). Partial correlation between changes in patient-reported cognitive symptoms (20-item Perceived Deficits Questionnaire-Depression; PDQ-D-20) and workplace productivity (Work Limitations Questionnaire; WLQ) was assessed at 12 and 52 weeks. Additional assessments included depression severity, cognitive performance, and patient-reported functioning. Structural equations model (SEM) analyses assessed causal relationships between changes in measures of cognition and functioning over time, adjusted for improvements in depressive symptoms. RESULTS Statistically significant improvements in all outcomes from baseline to week 52 were seen in the overall population and both subgroups (first treatment and switch). Response and remission rates were 77% and 56%, respectively. Improvements in PDQ-D-20 and WLQ productivity loss scores at weeks 12 and 52 were significantly correlated. SEM analyses found patient-rated cognitive symptoms (PDQ-D-20) at weeks 12 and 26 were significantly predictive (p < 0.05) of patient-reported functioning (Sheehan Disability Scale) at the subsequent visit. Depression severity and objectively measured cognitive performance did not significantly predict functional outcomes at any timepoint. CONCLUSION These results demonstrate the long-term benefits of vortioxetine treatment in working patients with MDD and emphasize the strong association between cognitive symptoms and functioning in a real-world setting.
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Sumiyoshi T, Watanabe K, Noto S, Sakamoto S, Moriguchi Y, Tan KHX, Hammer-Helmich L, Fernandez J. Relationship of cognitive impairment with depressive symptoms and psychosocial function in patients with major depressive disorder: Cross-sectional analysis of baseline data from PERFORM-J. J Affect Disord 2019; 258:172-178. [PMID: 31426015 DOI: 10.1016/j.jad.2019.07.064] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 07/08/2019] [Accepted: 07/29/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Evidence is accumulating for the presence of cognitive impairment in patients with major depressive disorder (MDD). The Prospective Epidemiological Research on Functioning Outcomes Related to Major Depressive Disorder in Japan (PERFORM-J) study is a 6-month, non-interventional, prospective, multicenter, epidemiological study. Using baseline data, the relationship between cognitive symptoms and psychosocial function was analyzed in Japanese patients with MDD. METHODS A total of 518 Japanese outpatients (aged 18-65 years) with MDD initiating new antidepressant monotherapy (first-line or switch from a previous drug) participated. Assessment measures were: physician-rated Montgomery-Asberg Depression Rating Scale (MADRS) (depression severity); Digit Symbol Substitution Test (DSST) (objective cognition); and patient-rated Perceived Deficits Questionnaire - Depression (PDQ-D) (subjective cognition); Sheehan Disability Scale (SDS); Work Productivity and Activity Impairment questionnaire (WPAI) (psychosocial function); and EuroQol-5 Dimension-5 Level (quality of life). RESULTS Over half of patients exhibited a greater than 1 standard deviation decline below norm in objective cognition, as measured by the DSST. Severity of depressive symptoms correlated positively with subjective (PDQ-D), but not objective (DSST) cognition. Depression severity and subjective cognition were significantly associated with psychosocial function, as measured by the SDS and WPAI (except the absenteeism items). Conversely, the association between objective cognition and psychosocial function was not significant. LIMITATIONS Only outpatients were recruited. Occupations and job-related stress levels were not taken into account. CONCLUSIONS Japanese patients with MDD presented a high incidence of cognitive impairment. The relationships between cognitive and psychosocial function in these patients suggest a need for therapeutics targeting cognitive impairment of MDD.
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Affiliation(s)
- Tomiki Sumiyoshi
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan; Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, Tokyo, Japan.
| | - Koichiro Watanabe
- Department of Neuropsychiatry, Kyorin University School of Medicine, Tokyo, Japan
| | - Shinichi Noto
- Department of Rehabilitation, Niigata University of Health and Welfare, Niigata, Japan
| | - Shigeru Sakamoto
- Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan
| | | | - Kristin Hui Xian Tan
- Health Economics & Epidemiology Statistics, Lundbeck Singapore Pte Ltd, Singapore
| | | | - Jovelle Fernandez
- Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan
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Habtamu K, Medhin G, Selamu M, Tirfessa K, Hanlon C, Fekadu A. Functional impairment among people diagnosed with depression in primary healthcare in rural Ethiopia: a comparative cross-sectional study. Int J Ment Health Syst 2019; 13:50. [PMID: 31346349 PMCID: PMC6635998 DOI: 10.1186/s13033-019-0305-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 07/10/2019] [Indexed: 12/24/2022] Open
Abstract
Background There have been few studies examining the functioning of clinically-diagnosed people with depression in primary healthcare (PHC) in low- and middle-income countries (LMICs). The aim of this study was to identify factors associated with functional impairment among people diagnosed with depression in PHC in Ethiopia as part of implementation of a task-shared model of mental healthcare. Methods A comparative cross-sectional study was conducted. As part of the Programme for Improving Mental health carE (PRIME), PHC clinicians were trained to diagnose depression using an adapted version of the World Health Organization (WHO) mental health Gap Action Programme (mhGAP). A total of 2038 adult consecutive PHC attendees were screened for depressive symptoms using the 9-item Patient Health Questionnaire (PHQ-9). Those who scored five or above on the PHQ-9 (n = 131) were assessed by PHC workers. Of these, 92 were diagnosed to have depression (“PHC diagnosed cases”) and the remaining 39 people were PHQ positive but considered not to have depression (“non-diagnosed controls”). PHC diagnosed cases were also compared to a community representative sample of adult healthy controls (n = 197; “community controls”). The 12-item version of the WHO Disability Assessment Schedule (WHODAS-2.0) was used to assess functional impairment. Multivariable negative binomial regression models were fitted to examine the association of demographic, social, economic and clinical characteristics with functional impairment. Results No significant difference in functional impairment was found between diagnosed cases and non-diagnosed controls. PHC diagnosed cases were found to have higher depressive symptom severity and suicidality, but lower social support compared to non-diagnosed controls (P < 0.05). In the multivariable model, greater functional impairment was associated with higher depressive symptoms (RR = 1.04; 95% CI 1.02, 1.05) and lower social support (RR = 0.96; 95% CI 0.95, 0.98). Diagnosed cases were found to have higher functional impairment compared to community controls (RR = 1.91; 95% CI 1.74, 2.09). Conclusion In this study, PHC clinicians identified cases of depression with high symptom burden, suicidality and functional impairment. These findings support current initiatives to scale-up mental health services at the PHC level; and indicate that social support is an important target for intervention.
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Affiliation(s)
- Kassahun Habtamu
- 1School of Psychology, College of Education and Behavioral Studies, Addis Ababa University, P.O.BOX: 1176, Addis Ababa, Ethiopia
| | - Girmay Medhin
- 2Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Medhin Selamu
- 3Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Kebede Tirfessa
- 3Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Charlotte Hanlon
- 3Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.,4Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, Centre for Global Mental Health, Kings College London, London, UK
| | - Abebaw Fekadu
- 3Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.,5Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, Centre for Affective Disorders, King's College London, London, UK.,6Global health & Infection, Brighton and Sussex Medical School, Brighton, UK
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Chokka P, Bougie J, Rampakakis E, Proulx J. Assessment in Work Productivity and the Relationship with Cognitive Symptoms (AtWoRC): primary analysis from a Canadian open-label study of vortioxetine in patients with major depressive disorder (MDD). CNS Spectr 2019; 24:338-347. [PMID: 29792585 PMCID: PMC6676443 DOI: 10.1017/s1092852918000913] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 02/21/2018] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The Assessment in Work Productivity and the Relationship with Cognitive Symptoms (AtWoRC) study aimed to assess the association between cognitive symptoms and work productivity in gainfully employed patients receiving vortioxetine for a major depressive episode (MDE). METHODS Patients diagnosed with major depressive disorder (MDD) and treated with vortioxetine independently of study enrollment were assessed over 52 weeks at visits that emulated a real-life setting. Patients were classified as those receiving vortioxetine as the first treatment for their current MDE (first treatment) or having shown inadequate response to a previous antidepressant (switch). The primary endpoint was the correlation between changes in patient-reported cognitive symptoms (20-item Perceived Deficits Questionnaire [PDQ-D-20]) and changes in work productivity loss (Work Limitations Questionnaire [WLQ]) at week 12. Additional assessments included changes in symptom and disease severity, cognitive performance, functioning, work loss, and safety. RESULTS In the week 12 primary analysis, 196 eligible patients at 26 Canadian sites were enrolled, received at least one treatment dose, and attended at least one postbaseline study visit. This analysis demonstrated a significant, strong correlation between PDQ-D-20 and WLQ productivity loss scores (r=0.634; p<0.001), and this correlation was significant in both first treatment and switch patients (p<0.001). A weaker correlation between Digit Symbol Substitution Test and WLQ scores was found (r=-0.244; p=0.003). CONCLUSION At 12 weeks, improvements in cognitive dysfunction were significantly associated with improvements in workplace productivity in patients with MDD, suggesting a role for vortioxetine in functional recovery in MDD.
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Affiliation(s)
- Pratap Chokka
- Grey Nuns Community Hospital, Edmonton, Alberta, Canada
| | | | | | - Jean Proulx
- Lundbeck Canada Inc., Montreal, Quebec, Canada
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Sun Y, Chen G, Wang L, Li N, Srisurapanont M, Hong JP, Hatim A, Chen CH, Udomratn P, Bae JN, Fang YR, Chua HC, Liu SI, George T, Bautista D, Chan E, Rush AJ, Yang H, Su YA, Si TM. Perception of Stigma and Its Associated Factors Among Patients With Major Depressive Disorder: A Multicenter Survey From an Asian Population. Front Psychiatry 2019; 10:321. [PMID: 31156476 PMCID: PMC6529583 DOI: 10.3389/fpsyt.2019.00321] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Accepted: 04/25/2019] [Indexed: 01/22/2023] Open
Abstract
Stigma of major depressive disorder (MDD) is an important public health problem. This study aimed to examine the level of perceived stigma and its associated factors in MDD patients in five Asian countries, including China, Korea, Malaysia, Singapore, and Thailand. A total of 547 outpatients with MDD were included from Asian countries. We used the stigma scale of the Explanatory Model Interview Catalogue (EMIC) to assess stigma. The Montgomery-Asberg Depression Rating Scale (MADRS), Symptoms Checklist 90-Revised (SCL-90-R), Fatigue Severity Scale (FSS), Sheehan Disability Scale (SDS), 36-Item Short-Form Health Survey (SF-36), and Multidimensional Scale of Perceived Social Support (MSPSS) were used to assess symptoms, clinical features, functional impairment, health status, and social support. The stigma scores of patients under 55 years old were significantly higher than those equal to or greater than 55 years old (P < 0.001). The stigma scores exhibited significant negative correlation with age; MSPSS scores of family, friends, and others; and SF-36 subscale of mental health, but significant positive correlation with MADRS, FSS, SDS, and SCL-90-R subscale scores of depression, interpersonal sensitivity, obsession-compulsion, psychoticism, and somatization. Multivariate regression analysis revealed that age, SCL-90-R interpersonal sensitivity, obsession-compulsion, psychoticism, MSPSS scores of friends and others, and SF-36 of mental health were significantly associated with the level of perceived stigma. These findings suggest that MDD patients who are young, have a high degree of interpersonal sensitivity and psychoticism, have low health-related quality of life, and have low social support are the target population for stigma interventions in Asia.
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Affiliation(s)
- Yan Sun
- Institute of Mental Health, Peking University Sixth Hospital, Beijing, China
- National Clinical Research Center for Mental Health Disorders and Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China
- Department of Psychiatry, Shanxi Dayi Hospital, Taiyuan, China
| | - Gang Chen
- Department of Psychiatry, Huai’an No.3 People’s Hospital, Jiangsu, China
| | - Li Wang
- Institute of Mental Health, Peking University Sixth Hospital, Beijing, China
- National Clinical Research Center for Mental Health Disorders and Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China
| | - Nan Li
- Department of Epidemiology, Peking University Third Hospital, Beijing, China
| | - Manit Srisurapanont
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Muang, Thailand
| | - Jin Pyo Hong
- Department of Psychiatry, University of Ulsan College of Medicine, Asian Medical Center, Seoul, South Korea
| | - Ahmad Hatim
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Chia-hui Chen
- Department of Psychiatry, Chang Gung Medical Center and Chang Gung University, Tao-Yuan, Taiwan
| | - Pichet Udomratn
- Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Jae Nam Bae
- Department of Psychiatry, Faculty of Medicine, Inha University Hospital, Incheon, South Korea
| | - Yi-Ru Fang
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hong Choon Chua
- Institute of Mental Health, Woodbridge Hospital, Singapore, Singapore
| | - Shen-Ing Liu
- Department of Psychiatry, Faculty of Medicine, Mackay Memorial Hospital, Taipei, Taiwan
| | - Tom George
- North West Specialist Centre, Everton Park, QLD, Australia
| | - Dianne Bautista
- Singapore Clinical Research Institute, Singapore, Singapore
- Duke-National University of Singapore Graduate Medical School, Singapore, Singapore
| | - Edwin Chan
- Singapore Clinical Research Institute, Singapore, Singapore
- Duke-National University of Singapore Graduate Medical School, Singapore, Singapore
| | - A. John Rush
- Singapore Clinical Research Institute, Singapore, Singapore
- Duke-National University of Singapore Graduate Medical School, Singapore, Singapore
| | - Hong Yang
- Department of Psychiatry, Shanxi Dayi Hospital, Taiyuan, China
| | - Yun-Ai Su
- Institute of Mental Health, Peking University Sixth Hospital, Beijing, China
- National Clinical Research Center for Mental Health Disorders and Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China
| | - Tian-Mei Si
- Institute of Mental Health, Peking University Sixth Hospital, Beijing, China
- National Clinical Research Center for Mental Health Disorders and Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China
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Levada OA, Troyan AS. Cognitive-functional relationships in major depressive disorder: Crucial data from a Ukrainian open-label study of vortioxetine versus escitalopram. J Affect Disord 2019; 250:114-122. [PMID: 30852363 DOI: 10.1016/j.jad.2019.03.040] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 02/20/2019] [Accepted: 03/04/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) is one of the most prevalent mental illnesses associated with impairments in different spheres of functioning. Cognitive deficits are currently investigated as a possible factor of functional decline. We aimed: 1) to assess the influence of cognitive domains among other MDD symptoms on functional impairment; 2) to compare effects of eight weeks` vortioxetine versus escitalopram treatments on cognitions and consequent influence on various domains of functioning. METHODS At baseline, 119 MDD (according to DSM-5, MADRS ≥ 7) patients and 71 healthy controls completed neurocognitive tests (RAVLT, TMT-B, DSST) and Sheehan Disability Scale. After 8 weeks of vortioxetine/escitalopram treatment, 56 patients had repeated clinical and neuropsychological evaluations. Linear regression analyses were performed to find significant predictors of impairment (at baseline) and improvement (after treatment) of functioning. Differences between groups after treatment were analyzed using mixed models for repeated measurements. RESULTS Cognitive impairments predominantly affected social functioning and were crucial for working productivity and total functioning along with anhedonia, hypothymia. Working memory disturbances impaired all aspects of functioning. Executive dysfunction made an additional contribution to workplace performance disturbances. At week 8, vortioxetine compared with escitalopram greater improved all impaired cognitive parameters and aspects of functioning and had higher remission rates. Cognitive improvement was the most significant factor for total functioning recovery and among crucial contributors to workplace performance recovery. LIMITATIONS No placebo group. CONCLUSION Cognitions play a key role in social, working, overall functioning in Ukrainian MDD patients. Compared to escitalopram, vortioxetine treatment greater improves all cognitive and functioning domains, which leads to higher remission rates.
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Affiliation(s)
- Oleg A Levada
- Psychiatry Course, State Institution "Zaporizhzhia Medical Academy of Postgraduate Education Ministry of Health of Ukraine", 20 Winter Boulevard, Zaporizhzhia 69096, Ukraine
| | - Alexandra S Troyan
- Psychiatry Course, State Institution "Zaporizhzhia Medical Academy of Postgraduate Education Ministry of Health of Ukraine", 20 Winter Boulevard, Zaporizhzhia 69096, Ukraine.
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Tourjman SV, Juster RP, Purdon S, Stip E, Kouassi E, Potvin S. The screen for cognitive impairment in psychiatry (SCIP) is associated with disease severity and cognitive complaints in major depression. Int J Psychiatry Clin Pract 2019; 23:49-56. [PMID: 29553848 DOI: 10.1080/13651501.2018.1450512] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To assess the relationship between the Screen for Cognitive Impairment in Psychiatry (SCIP) score and illness severity, subjective cognition and functioning in a cohort of major depressive disorder (MDD) patients. METHODS Patients (n = 40) diagnosed with MDD (DSM-IV-TR) completed the SCIP, a brief neuropsychological test, and a battery of self-administered questionnaires evaluating functioning (GAF, SDS, WHODAS 2.0, EDEC, PDQ-D5). Disease severity was evaluated with the Hamilton Depression Rating Scale (HDRS) and the Clinical Global Impression (CGI). RESULTS Age and sex were associated with performance in the SCIP. The SCIP-Global index score was associated with disease severity (r = -0.316, p < .05), the SDS, a patient self-assessment of daily functioning (r = -0.368, p < .05), and the EDEC subscales of patient-reported cognitive deficits (r = -0.388, p < .05) and their functional impacts (r = -0.335, p < .05). Multivariate analysis adjusted for age and sex confirmed these tests are independent predictors of performance in the SCIP (CGI-S, F[3,34] = 4.478, p = .009; SDS, F[3,34] = 3.365, p = .030; EDEC-perceived cognitive deficits, F[3,34] = 5.216, p = .005; EDEC-perceived impacts of functional impairment, F[3,34] = 5.154, p = .005). CONCLUSIONS This study confirms that the SCIP can be used during routine clinical evaluation of MDD, and that cognitive deficits objectively assessed in the SCIP are associated with disease severity and self-reported cognitive dysfunction and impairment in daily life.
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Affiliation(s)
| | | | - Scot Purdon
- c Department of Psychiatry , University of Alberta , Edmonton , Canada
| | - Emmanuel Stip
- d Department of Psychiatry , University of Montreal , Montreal , Canada
| | - Edouard Kouassi
- a Institut Universitaire en Santé Mentale de Montréal , Montreal , Canada
| | - Stéphane Potvin
- a Institut Universitaire en Santé Mentale de Montréal , Montreal , Canada
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Zainal NZ, Kalita P, Herr KJ. Cognitive dysfunction in Malaysian patients with major depressive disorder: A subgroup analysis of a multicountry, cross-sectional study. Asia Pac Psychiatry 2019; 11:e12346. [PMID: 30511420 DOI: 10.1111/appy.12346] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 10/31/2018] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Cognitive dysfunction has been significantly associated with functional impairment in patients with major depressive disorder (MDD). METHODS This is a subgroup analysis of 211 Malaysian patients recruited from the multicountry, multicenter, cross-sectional Cognitive Dysfunction in Asian patients with Depression (CogDAD) study. Depression severity, cognitive dysfunction, and functional disability were assessed and compared with the overall CogDAD study population. Factors associated with functional disability were also evaluated in this Malaysian patient population. RESULTS Approximately half of the Malaysian patients were in their first depressive episode, with the majority being treated for mild-to-moderate depression. Furthermore, Malaysian patients experienced cognitive dysfunction, with self-reported Perceived Deficits Questionnaire (PDQ-D) scores falling within the third quartile of PDQ-D severity. Malaysian patients also reported functional disability evidenced by a mean total Sheehan Disability Scale (SDS) score of 11.47 ± 6.68, with the highest SDS score reported in the "Social Life/Leisure Activities" domain. Compared with the overall CogDAD study population, the Malaysian patient population had comparable patient demographics in terms of marital and working status; outcome scores for PHQ-9 (9-item Patient Health Questionnaire for self-reported depression severity), PDQ-D and SDS; and worst perceived cognitive dysfunction reported in the "Attention/Concentration" domain. Factors found to be significantly associated with functional disability were PDQ-D score, sick leave taken, and antidepressant treatment (P < 0.05). DISCUSSION Findings from this subgroup analysis highlight the significance of treating cognitive dysfunction in patients with MDD and its correlation to functional disability.
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Affiliation(s)
- Nor Zuraida Zainal
- Department of Psychological Medicine, University Malaya, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Pranab Kalita
- Lundbeck South East Asia, Medical Affairs, Lundbeck Singapore Pte. Ltd., Singapore
| | - Keira Joann Herr
- Lundbeck South East Asia, Medical Affairs, Lundbeck Singapore Pte. Ltd., Singapore
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Haro JM, Hammer-Helmich L, Saragoussi D, Ettrup A, Larsen KG. Patient-reported depression severity and cognitive symptoms as determinants of functioning in patients with major depressive disorder: a secondary analysis of the 2-year prospective PERFORM study. Neuropsychiatr Dis Treat 2019; 15:2313-2323. [PMID: 31616147 PMCID: PMC6698581 DOI: 10.2147/ndt.s206825] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 06/17/2019] [Indexed: 01/24/2023] Open
Abstract
PURPOSE To investigate the temporal interrelationship between depression severity, cognitive symptoms, and functioning in patients with major depressive disorder (MDD) in the PERFORM study (NCT01427439). PATIENTS AND METHODS PERFORM was a 2-year, multicenter, prospective, noninterventional cohort study in outpatients with MDD who were either initiating antidepressant monotherapy or undergoing their first switch of antidepressant. Patients were enrolled by a general practitioner or psychiatrist. Structural equation model (SEM) analysis was used to explore temporal associations between patient-reported depression severity (9-item Patient Health Questionnaire score), cognitive symptoms (5-item Perceived Deficits Questionnaire score), and functional impairment (Sheehan Disability Scale total score). Standardized regression coefficients (SRCs) were used to evaluate the relationship between each outcome and scores from the most recent prior visit over the 2 years of follow-up. RESULTS Between February 25, 2011, and February 19, 2015, 1,159 eligible patients with MDD completed the baseline and ≥1 follow-up visit at 194 sites in five European countries (France, Germany, Spain, Sweden, and the UK). Overall, 1,090 patients had assessments for ≥1 outcome measure at two consecutive visits. Severity of cognitive symptoms at baseline and Months 2 and 18 predicted functional impairment at Months 2, 6, and 24, respectively (SRC: 0.18, 0.15, and 0.22; P<0.001). Depression severity at Months 2, 6, and 12 predicted functional impairment at Months 6, 12, and 18, respectively (SRC: 0.17, 0.25, and 0.22; P<0.001). Severity of cognitive symptoms at baseline and Month 18 predicted depression severity at Months 2 and 24, respectively (SRC: 0.19 and 0.22; P<0.001). Functional impairment did not significantly predict the severity of depression or cognitive symptoms, and depression severity did not significantly predict the severity of cognitive symptoms at any time point. CONCLUSION Patient-reported severity of cognitive symptoms appears to be an independent and significant determinant of subsequent functional impairment and depression severity in patients with MDD.
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Affiliation(s)
- Josep Maria Haro
- Research and Teaching Unit, Parc Sanitari Sant Joan De Deu, CIBERSAM, University of Barcelona, Sant Boi De Llobregat, Barcelona, Spain
| | | | - Delphine Saragoussi
- Real World Evidence and Epidemiology, Lundbeck SAS, Issy-les-Moulineaux, France
| | - Anders Ettrup
- Medical Affairs, Vortioxetine, H. Lundbeck A/S, Valby, Denmark
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Knight MJ, Baune BT. Social cognitive abilities predict psychosocial dysfunction in major depressive disorder. Depress Anxiety 2019; 36:54-62. [PMID: 30211966 DOI: 10.1002/da.22844] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Revised: 08/21/2018] [Accepted: 09/02/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Major depressive disorder (MDD) is associated with social cognitive deficits (e.g., poor affect recognition and impaired theory of mind). However, the contribution of social cognitive issues to psychosocial dysfunction in MDD (e.g., occupational functioning and interpersonal relationships) has not been investigated. The current study evaluated the relationship between specific social cognitive domains (e.g., prosody interpretation) and psychosocial dysfunction in subjects with lifetime MDD, as well as currently depressed, remitted, and healthy controls (HCs) subjects. METHOD Data were obtained from 213 participants in the Cognitive Function and mood study (CoFaMS), a cross-sectional study of mood, social cognition, cold cognition, and psychosocial functioning in mood disorders. Participants' (current MDD n = 42, remitted MDD n = 69, and HCs n = 102) social cognitive abilities were assessed using the Social Perception subtest of the Wechsler Adult Intelligence Scale, and psychosocial dysfunction was clinically evaluated with the Functioning Assessment Short Test (FAST). RESULTS The results indicated that prosody interpretation, but not facial affect or meaning interpretation, was associated with psychosocial dysfunction in subjects with lifetime MDD, as well as remitted MDD subjects relative to HCs. In contrast, social cognition was not associated with functioning in participants with current MDD or in HCs. CONCLUSIONS These results suggest that the relationship between social cognition and psychosocial functioning differs between the acute and remitted stage of illness in MDD, and that prosody interpretation should be considered a treatment target in patients with residual psychosocial issues.
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Affiliation(s)
- Matthew J Knight
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Bernhard T Baune
- Department of Psychiatry, Melbourne Medical School, University of Melbourne, Melbourne, VIC, Australia
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Discrepancy between objective and subjective cognition in major depressive disorder. Eur Neuropsychopharmacol 2019; 29:46-56. [PMID: 30503099 DOI: 10.1016/j.euroneuro.2018.11.1104] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 10/27/2018] [Accepted: 11/09/2018] [Indexed: 12/25/2022]
Abstract
Objective and subjective cognitive measures are altered in major depressive disorder (MDD), but there is a poor correlation between them. This study aims to explore such discrepancy and the characteristics explaining this phenomenon. 229 patients with MDD subdivided into remitted (n = 57), partially remitted (n = 90) and acute (n = 82) underwent a clinical interview, completed self-report questionnaires and a neuropsychological assessment. The association between objective and subjective cognition was evaluated in the areas of attention and memory. Also, dependent measures of concordance and self-appraisal were calculated for each patient. Potential predictors of these outcomes were evaluated through regression analysis. Depressive symptoms correlated negatively with objective but especially with subjective cognition. Patients in an acute episode showed a significant correlation between objective and subjective attention/memory measures, but also the greatest underestimation of their cognitive performance. In those with fewer depressive symptoms, objective and subjective cognition showed poor correspondence between them. In the regression analyses with the full MDD sample, higher scores on depressive symptoms, intelligence quotient and executive functions predicted lower self-appraisal. Objective and subjective cognition show poor concordance in MDD patients, especially in those with residual mood symptoms. Higher executive functions also explain this discrepancy. Assessments of both subjective cognitive complaints and objective performance seem necessary as they may be measuring different aspects of cognitive functioning.
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Cambridge OR, Knight MJ, Mills N, Baune BT. The clinical relationship between cognitive impairment and psychosocial functioning in major depressive disorder: A systematic review. Psychiatry Res 2018; 269:157-171. [PMID: 30149273 DOI: 10.1016/j.psychres.2018.08.033] [Citation(s) in RCA: 96] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 08/12/2018] [Accepted: 08/12/2018] [Indexed: 11/18/2022]
Abstract
Cognitive deficits are frequently observed in major depressive disorder (MDD), as well as impaired long-term psychosocial functioning. However, the relationship between cognitive deficits and psychosocial functioning in MDD is under-investigated. We aim to systematically review the literature on the relationship between specific cognitive impairments and psychosocial functioning in MDD. We systematically reviewed English-language literature in PubMed, PsychINFO, Scopus and Web of Science using search terms related to psychosocial functioning. Additional studies were identified by searching reference lists. Following our inclusion/exclusion criteria, 28 studies were reviewed. Inclusion criteria included age (> 18), MDD diagnosed by standard tools (e.g., DSM-IV), use of cognitive and psychosocial assessments. Cross-sectional studies indicated that cognitive deficits in domains of executive functioning, attention, memory, and global cognition are associated with psychosocial dysfunction in domains of as quality of life, and social, occupational, and global functioning. The cognition-functioning relationship was also observed in longitudinal studies, showing that only specific cognitive domains affected psychosocial outcomes over the long-term course of illness. Older age and greater MDD symptom severity appear to enhance cognition-psychosocial dysfunction relationship, however little is known regarding the role of a number of other clinical factors (e.g., psychosis, illness duration).
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Affiliation(s)
- Olivia R Cambridge
- Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Melbourne, VIC 3010, AUSTRALIA
| | - Matthew J Knight
- Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Melbourne, VIC 3010, AUSTRALIA
| | - Natalie Mills
- Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Melbourne, VIC 3010, AUSTRALIA
| | - Bernhard T Baune
- Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Melbourne, VIC 3010, AUSTRALIA.
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Sumiyoshi T, Watanabe K, Noto S, Sakamoto S, Moriguchi Y, Okamoto S. Prospective Epidemiological Research on Functioning Outcomes Related to Major Depressive Disorder in Japan (PERFORM-J): Protocol for a Prospective Cohort Study. JMIR Res Protoc 2018; 7:e161. [PMID: 29941418 PMCID: PMC6037943 DOI: 10.2196/resprot.9682] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 03/14/2018] [Accepted: 03/31/2018] [Indexed: 12/12/2022] Open
Abstract
Background Patients with major depressive disorder may exhibit cognitive dysfunction that can affect functional outcomes. However, the prevalence and burden of cognitive dysfunction in Japanese patients with MDD have not been thoroughly examined. Objective To investigate the time course (over 6 months) of several functional outcomes during treatment with antidepressants in Japanese patients with major depressive disorder. The primary objective is to assess longitudinal changes in cognitive function and depressive symptoms, using both clinician-rated and patient-rated scales. The study incorporates assessments of cognitive function and other functional outcomes (functional capacity, disability, work productivity and impairments of activity, and quality of life), as well as depressive symptoms. Methods PERFORM-J (Prospective Epidemiological Research on Functioning Outcomes Related to Major Depressive Disorder in Japan) is a 6-month, prospective, multi-center, epidemiological cohort study. Participants are Japanese outpatients aged 18-65 years with a recurrent or new diagnosis of a major depressive episode (according to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision [DSM-IV-TR]), who are initiating a new antidepressant as monotherapy (either as first-line therapy or after switching from a previous antidepressant). Eligible patients are evaluated objectively during four visits (at baseline and at Months 1, 2, and 6) using physician-rated assessments of severity of depressive symptoms, cognitive function, and functional capacity. Subjective, patient-reported, outcomes are also assessed as indicators of depressive symptoms, disability, work productivity or impairments of activity, and perceived cognitive dysfunction. Results The study began in September 2016. Patient enrollment was completed on June 30, 2017, with 523 patients having been enrolled from 48 study sites. As of October, 2017, 279 patients had completed the study. Conclusions PERFORM-J is expected to provide valuable information on the longitudinal relationship between cognitive dysfunction, depressive symptoms, and other functional outcomes in Japanese patients with major depressive disorder who initiate monotherapy with antidepressants. Trial Registration UMIN Clinical Trials Registry UMIN000024320; https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi? recptno=R000028011 (Archived by WebCite at http://www.webcitation.org/70K7W9PgC). Registered Report Identifier RR1-10.2196/9682
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Affiliation(s)
- Tomiki Sumiyoshi
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.,Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Koichiro Watanabe
- Department of Neuropsychiatry, Kyorin University School of Medicine, Tokyo, Japan
| | - Shinichi Noto
- Department of Health Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Shigeru Sakamoto
- Japan Medical Affairs, Japan Pharma Business Unit, Takeda Pharmaceutical Company Limited, Tokyo, Japan
| | | | - Shuichi Okamoto
- Japan Medical Affairs, Japan Pharma Business Unit, Takeda Pharmaceutical Company Limited, Tokyo, Japan
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Srisurapanont M, Mok YM, Yang YK, Chan HN, Della CD, Zainal NZ, Jambunathan S, Amir N, Kalita P. Cognitive complaints and predictors of perceived cognitive dysfunction in adults with major depressive disorder: Findings from the Cognitive Dysfunction in Asians with Depression (CogDAD) study. J Affect Disord 2018; 232:237-242. [PMID: 29499506 DOI: 10.1016/j.jad.2018.02.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 01/07/2018] [Accepted: 02/15/2018] [Indexed: 10/18/2022]
Abstract
BACKGROUND Several studies have described the presence of perceived cognitive dysfunction amongst Asian patients with major depressive disorder (MDD). To date, no study has been conducted investigating the predictors of perceived cognitive dysfunction amongst Asian MDD patients. METHODS This was a post-hoc analysis of the Cognitive Dysfunction in Asian patients with Depression (CogDAD) study. Descriptive statistics were used to describe the most common cognitive complaints by patients. Univariate and multivariate analyses were performed to determine variables associated with perceived cognitive dysfunction (Perceived Deficit Questionnaire-Depression, PDQ-D). RESULTS The CogDAD study population is comprised of MDD patients with mild-to-moderate depression (Patient Health Questionnaire 9-item [PHQ-9]: 11.3 ± 6.9) who reported perceived cognitive dysfunction (PDQ-D = 22.6 ± 16.2). The most common cognitive complaints were: mind drifting (42.3%), trouble making decision (39.6%) and trouble concentrating (38.0%). Predictors of perceived cognitive dysfunction were: being Southeast Asians (vs. Taiwanese) (p < 0.001), current episode longer than 8 weeks (vs. 1-8 weeks) (p < 0.05), the presence of disability (vs. no disability) (p < 0.05), younger age (p < 0.01), and higher PHQ-9 total scores (p < 0.001). LIMITATIONS The causal relationship between predictive variables and PDQ-D could not be tested due to the cross-sectional nature of the study. Furthermore, a neuropsychological test was not included in the CogDAD study and use of concomitant medications, including anti-depressants, could have impacted patient's perceived cognitive ability. CONCLUSIONS The present study results suggest a potential role for subjective cognitive assessment in patients with MDD who are young, with long durations of depression or severe depression.
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Affiliation(s)
- Manit Srisurapanont
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
| | - Yee Ming Mok
- Department of Mood and Anxiety, Institute of Mental Health, Singapore
| | - Yen Kuang Yang
- Department of Psychiatry, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | | | - Constantine D Della
- Department of Psychiatry & Behavioral Medicine, College of Medicine & Philippine General Hospital, University of the Philippines, Manila, Philippines
| | - Nor Zuraida Zainal
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Stephen Jambunathan
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nurmiati Amir
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia, Jakata, Indonesia
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Park SC, Lee MS, Hahn SW, Kanba S, Chong MY, Chee KY, Udomratn P, Tripathi A, Sartorius N, Shinfuku N, Tanra AJ, Park YC. Clinical Characteristics and Psychotropic Prescribing Patterns Associated with impaired Concentration in Asians with Depressive Disorders: The REAP-AD Study. TOHOKU J EXP MED 2018. [PMID: 28637942 DOI: 10.1620/tjem.242.151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The Research on Asian Psychotropic Prescription Patterns for Antidepressants (REAP-AD) study aimed to survey and review antidepressant prescribing patterns in different clinical settings in Asian countries/areas. The REAP-AD study collected comprehensive data for psychiatric patients prescribed antidepressants in 10 Asian countries/areas during the period from March to June 2013. Depressive disorders have been an important issue closely associated with ill-health and disability in the realm of mental health. Impaired concentration was found to be a consistent symptom in depressive disorders regardless of clinical course, and a predictor of poor treatment outcome. In this work we aimed to identify clinical characteristics independently associated with impaired concentration in patients with depressive disorders, using data from the REAP-AD study. A total of 336 depressive disorder patients with impaired concentration and 786 depressive disorder patients without impaired concentration were recruited from 40 centers in 10 Asian countries/areas. A binary logistic regression model was fitted to identify the independent correlates of impaired concentration in patients with depressive disorders. After adjusting the effects of covariates, the binary logistic model showed that impaired concentration was independently associated with higher rates of loss of interest (P < 0.0001), fatigue (P < 0.0001), low self-confidence (P < 0.0001) and appetite disturbance (P < 0.0001) and with a lower rate of adjunctive antipsychotic prescription (P = 0.007). Our findings suggest that impaired concentration and its associated depressive symptom profiles constitute a unitary depressive symptom cluster that is also an intervening variable for poor social function.
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Affiliation(s)
- Seon-Cheol Park
- Department of Psychiatry, Inje University College of Medicine and Haeundae Paik Hospital
| | - Min-Soo Lee
- Department of Psychiatry, Korea University College of Medicine
| | - Sang Woo Hahn
- Department of Psychiatry, Soonchunhyang University Seoul Hospital
| | - Shigenobu Kanba
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University
| | - Mian-Yoon Chong
- Chang Gung Memorial Hospital, Chiayi, and Chang Gung University School of Medicine
| | - Kok Yoon Chee
- Department of Psychiatry and Mental Health, Tunku Abdul Rahman Institute of Neuroscience, Kuala Lumpur Hospital
| | - Pichet Udomratn
- Department of Psychiatry, Faculty of Medicine, Prince of Songkla University
| | | | | | - Naotaka Shinfuku
- Department of Social Welfare, School of Human Sciences, Seinan Gakuin University
| | - Andi J Tanra
- Department of Psychiatry, Hasanuddin University Faculty of Medicine
| | - Yong Chon Park
- Department of Neuropsychiatry, Hanyang University Guri Hospital
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Baune BT, Sluth LB, Olsen CK. The effects of vortioxetine on cognitive performance in working patients with major depressive disorder: A short-term, randomized, double-blind, exploratory study. J Affect Disord 2018; 229:421-428. [PMID: 29331703 DOI: 10.1016/j.jad.2017.12.056] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 12/13/2017] [Accepted: 12/27/2017] [Indexed: 12/23/2022]
Abstract
BACKGROUND Major Depressive Disorder (MDD) is a complex disease characterized by emotional, physical and cognitive symptoms. We explored the efficacy of vortioxetine versus placebo on outcomes of cognition, functioning and mood symptoms in working patients with depression, using paroxetine as an active reference. METHODS Gainfully employed patients (18-65 years, N = 152) with MDD were randomized 1:1:1 to 8 weeks' double-blind, parallel treatment either with vortioxetine (10mg/day) or paroxetine (20mg/day), or with placebo. The primary efficacy measure was the Digit Symbol Substitution Test (DSST), analyzed using a mixed model for repeated measurements, and the key secondary efficacy measure was the University of San Diego Performance-based Skills Assessment - Brief (UPSA-B), analyzed using analysis of covariance (last observation carried forward). RESULTS At week 8, DSST and UPSA-B performance had improved relative to baseline in all treatment groups, with no statistically significant differences between treatment groups. While improvements in mood were comparable for vortioxetine and paroxetine, numerical improvements in cognitive performance (DSST) were larger with vortioxetine. Vortioxetine significantly improved overall cognitive performance and clinician-rated functioning relative to placebo. The majority of adverse events were mild or moderate, with nausea being the most common adverse event for vortioxetine. LIMITATIONS Small sample sizes implied limited statistical power. CONCLUSION This explorative study showed no significant differences versus placebo in DSST or UPSA-B performance at week 8. However, secondary results support vortioxetine as an effective and well-tolerated antidepressant, supporting an added benefit for cognition and functioning, which could have particular therapeutic relevance for the working patient population.
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Affiliation(s)
- Bernhard T Baune
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Australia.
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Younossi ZM, Chan HLY, Dan YY, Lee MH, Lim YS, Kruger E, Tan SC. Impact of ledipasvir/sofosbuvir on the work productivity of genotype 1 chronic hepatitis C patients in Asia. J Viral Hepat 2018; 25:228-235. [PMID: 29053909 DOI: 10.1111/jvh.12808] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 08/30/2017] [Indexed: 12/16/2022]
Abstract
Chronic, untreated hepatitis C virus (HCV) infection is associated with a poor clinical prognosis and a detrimental impact on patients' lives, including on work productivity. To estimate the value of productivity losses due to genotype 1 (GT1) HCV infection in Hong Kong, Singapore, South Korea and Taiwan and to estimate the potential productivity gains associated with treating patients with ledipasvir/sofosbuvir (LDV/SOF) therapy, an economic model was developed with a time horizon of 1 year. Hepatitis C virus patients entered the model at 12 weeks post-treatment, having achieved or not achieved sustained virological response (SVR). Absenteeism and presenteeism rates were taken from a pooled analysis of data from the ION 1-3 studies. These rates were converted into hours of lost productivity, multiplied by the average wage and applied to the total employed, adult GT1 population in each country. Results were compared assuming no treatment, and assuming all patients were treated with LDV/SOF. Total productivity losses due to untreated HCV were: $11.3 million, $17.1 m, $146.0 m and $349.1 m in Hong Kong, Singapore, South Korea and Taiwan. LDV/SOF treatment resulted in economic gains of $4.5 m, $6.8 m, $58.7 m and $138 m, respectively. These gains were due to reduced presenteeism. The results were sensitive to changes in the prevalence of HCV and the average wage. In conclusion, productivity losses due to untreated HCV infection represent a substantial economic burden. By instituting universal HCV treatment with LDV/SOF (or other therapies with high SVR rates), productivity gains can be achieved.
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Affiliation(s)
- Z M Younossi
- Center for Liver Diseases, Department of Medicine, Inova Fairfax Hospital, Falls Church, VA, USA.,Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, USA
| | - H L Y Chan
- Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Y Y Dan
- University Medicine Cluster, National University Hospital, Singapore City, Singapore
| | - M H Lee
- National Yang-Ming University, Taipei, Taiwan
| | - Y-S Lim
- Department of Gastroenterology, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, South Korea
| | - E Kruger
- IMS Health, Singapore City, Singapore
| | - S C Tan
- IMS Health, Singapore City, Singapore
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Hammer-Helmich L, Haro JM, Jönsson B, Tanguy Melac A, Di Nicola S, Chollet J, Milea D, Rive B, Saragoussi D. Functional impairment in patients with major depressive disorder: the 2-year PERFORM study. Neuropsychiatr Dis Treat 2018; 14:239-249. [PMID: 29386897 PMCID: PMC5767094 DOI: 10.2147/ndt.s146098] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The Prospective Epidemiological Research on Functioning Outcomes Related to Major depressive disorder (PERFORM) study describes the course of depressive symptoms, perceived cognitive symptoms, and functional impairment over 2 years in outpatients with major depressive disorder (MDD) and investigates the patient-related factors associated with functional impairment. METHODS This was a 2-year observational study in 1,159 outpatients with MDD aged 18-65 years who were either initiating antidepressant monotherapy or undergoing their first switch of antidepressant. Functional impairment was assessed by the Sheehan Disability Scale and the Work Productivity and Activity Impairment questionnaire. Patients assessed depression severity using the nine-item Patient Health Questionnaire and severity of perceived cognitive symptoms using the five-item Perceived Deficit Questionnaire. To investigate which patient-related factors were associated with functional impairment, univariate analyses of variance were performed to identify relevant factors that were then included in multivariate analyses of covariance at baseline, month 2, months 6 and 12 combined, and months 18 and 24 combined. RESULTS The greatest improvement in depressive symptoms, perceived cognitive symptoms, and functional impairment was seen immediately (within 2 months) following initiation or switch of antidepressant therapy, followed by more gradual improvement and long-term stabilization. Improvement in perceived cognitive symptoms was less marked than improvement in depressive symptoms during the acute treatment phase. Functional impairment in patients with MDD was not only associated with severity of depressive symptoms but also independently associated with severity of perceived cognitive symptoms when adjusted for depression severity throughout the 2 years of follow-up. CONCLUSION These findings highlight the burden of functional impairment in MDD and the importance of recognizing and managing cognitive symptoms in daily practice.
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Affiliation(s)
| | - Josep Maria Haro
- Research and Teaching Unit, Parc Sanitari Sant Joan de Deu, CIBERSAM, University of Barcelona, Barcelona, Spain
| | - Bengt Jönsson
- Department of Economics, Stockholm School of Economics, Stockholm, Sweden
| | | | | | - Julien Chollet
- Clinical Operations, Lundbeck SAS, Issy-les-Moulineaux, France
| | - Dominique Milea
- Health Economics and Epidemiology, Lundbeck Singapore Pte. Ltd, Singapore, Singapore
| | - Benoît Rive
- Global Analytics, Lundbeck SAS, Issy-les-Moulineaux, France
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Saragoussi D, Christensen MC, Hammer-Helmich L, Rive B, Touya M, Haro JM. Long-term follow-up on health-related quality of life in major depressive disorder: a 2-year European cohort study. Neuropsychiatr Dis Treat 2018; 14:1339-1350. [PMID: 29872301 PMCID: PMC5973321 DOI: 10.2147/ndt.s159276] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Major depressive disorder (MDD) is associated with significant impairments in health-related quality of life (HRQoL) and everyday functioning. This cohort study investigated the long-term development of HRQoL in patients with MDD and its association with patient characteristics, including depressive symptom severity and cognitive symptoms. METHODS The Prospective Epidemiological Research on Functioning Outcomes Related to Major depressive disorder (PERFORM) study was a longitudinal cohort study conducted in 1,159 outpatients aged 18-65 years with MDD in France, Germany, Spain, Sweden, and the UK. The patients were either initiating antidepressant monotherapy or undergoing their first switch of antidepressant. HRQoL was assessed using the Medical Outcomes Study Short-Form 12-item Health Survey (SF-12) up to month 12 and the EuroQol Five Dimensions questionnaire up to month 24 (UK only). Depressive symptom severity was assessed up to month 24 by the patient-reported Patient Health Questionnaire and cognitive symptoms by the Perceived Deficit Questionnaire. Multivariate analyses were performed to identify patient characteristics associated with HRQoL. RESULTS Mental HRQoL was severely impaired at baseline versus normative data (mean [SD] SF-12 mental component summary [MCS], 26.5 [9.2]); mean (SD) physical component summary (PCS) total score was 45.2 (12.1). SF-12 MCS improved over 12 months of follow-up (38.7 [11.6] at month 12), while SF-12 PCS remained stable (45.3 [11.1]). At each assessment time point, there was a clear pattern of lower SF-12 MCS and PCS total score in patients experiencing greater cognitive problems. The mean EuroQol Five Dimensions questionnaire utility index score generally decreased (i.e., worsened) with increasing severity of cognitive and depressive symptoms at all time points up to 24 months. Multivariate analyses identified both depression severity and cognitive symptoms as strongly and significantly associated with poor HRQoL. CONCLUSION These findings highlight the importance of recognizing and managing residual symptoms in patients with MDD, including the cognitive symptoms, to restore long-term psychosocial functioning.
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Affiliation(s)
- Delphine Saragoussi
- Real-World Evidence and Epidemiology, Lundbeck SAS, Issy-les-Moulineaux, France
| | | | | | - Benoît Rive
- Global Analytics, Lundbeck SAS, Issy-les-Moulineaux, France
| | - Maëlys Touya
- Health Economics and Outcomes Research, Lundbeck, Deerfield, IL, USA
| | - Josep Maria Haro
- Research and Teaching Unit, Parc Sanitari Sant Joan de Deu, CIBERSAM, University of Barcelona, Sant Boi de Llobregat, Barcelona, Spain
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Manit S, Yee Ming M, Yen Kuang Y, Herng-Nieng C, Constantine D D, Zuraida ZN, Stephen J, Nurmiati A, Pranabi K. Cognitive Dysfunction in Asian Patients with Depression (CogDAD): A Cross-Sectional Study. Clin Pract Epidemiol Ment Health 2017; 13:185-199. [PMID: 29238395 PMCID: PMC5712642 DOI: 10.2174/1745017901713010185] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 10/04/2017] [Accepted: 10/07/2017] [Indexed: 01/20/2023]
Abstract
BACKGROUND Cognitive dysfunction is a predominant symptom of Major Depressive Disorder (MDD), contributing to functional impairment. OBJECTIVE The primary objective of this study was to assess and describe perceived cognitive dysfunction amongst Asian patients diagnosed with MDD. The secondary objective was to explore the associations between depression severity, perceived cognitive dysfunction and functional disability. METHODS This was a multi-country, multi-centre, cross-sectional study. Adults with a current episode of MDD were recruited from 9 university/general hospital clinics in Asia. During a single study visit, psychiatrists assessed depression severity (Clinical Global Impression-Severity, CGI-S); patients completed questionnaires assessing depression severity (Patient Health Questionnaire-9 items, PHQ-9), perceived cognitive dysfunction (Perceived Deficit Questionnaire-Depression, PDQ-D) and functional disability (Sheehan Disability Scale, SDS). RESULTS Patients (n=664), predominantly women (66.3%), were aged 46.5±12.5 years, lived in urban areas (81.3%) and were employed (84.6%). 51.5% of patients were having their first depressive episode; 86.7% were receiving treatment; 82.2% had a current episode duration >8 weeks. Patients had mild-to-moderate depression (CGI-S=3.3±1.0; PHQ-9=11.3±6.9). Patients reported perceived cognitive dysfunction (PDQ-D=22.6±16.2) and functional disability (SDS=11.3±7.9). PHQ-9, PDQ-D and SDS were moderately-to-highly correlated (PHQ-9 and SDS: r=0.72; PHQ-9 and PDQ-D: r=0.69; PDQ-D and SDS, r=0.63). ANCOVA showed that after controlling for patient-reported depression severity (PHQ-9), perceived cognitive dysfunction (PDQ-D) was significantly associated with functional disability (SDS) (p<0.001). CONCLUSIONS Asian patients with MDD reported perceived cognitive dysfunction. There is a need for physicians to evaluate cognitive dysfunction in the clinical setting in order to reach treatment goals, including functional recovery beyond remission of mood symptoms.
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Affiliation(s)
- Srisurapanont Manit
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Mok Yee Ming
- Institute of Mental Health, View, Buangkok Green Medical Park, Buangkok, Singapore
| | - Yang Yen Kuang
- Department of Psychiatry, National Cheng Kung University, Cheng Kung National University Hospital, Tainan, Taiwan
| | - Chan Herng-Nieng
- Department of Psychiatry, Singapore General Hospital, Academia, Singapore
| | | | - Zainal, Nor Zuraida
- University Malaya, Jalan Universiti, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Jambunathan Stephen
- Department of Psychiatry, Cipto Mangunkusumo Hospital, University of Indonesia, Jakarta Pusat, Indonesia
| | - Amir Nurmiati
- Department of Psychiatry, Cipto Mangunkusumo Hospital, University of Indonesia, Jakarta Pusat, Indonesia
| | - Kalita Pranabi
- Lundbeck Singapore Pte. Ltd., 101 Thomson Road, Singapore
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Srisurapanont M, Suttajit S, Eurviriyanukul K, Varnado P. Discrepancy between objective and subjective cognition in adults with major depressive disorder. Sci Rep 2017; 7:3901. [PMID: 28634383 PMCID: PMC5478612 DOI: 10.1038/s41598-017-04353-w] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 05/12/2017] [Indexed: 11/09/2022] Open
Abstract
This study aimed to determine: i) the correlation between objective and subjective cognition, ii) the correlates of objective and subjective cognition and iii) the predictors of discrepancy between objective and subjective cognition. Participants were non-elderly patients with major depressive disorder (MDD). We assessed subjective cognition using the Perceived Deficit Questionnaire for Depression (PDQ-D) and objective cognition using Face I and Face II tests of the Wechsler Memory Scale, 3rd edition and Digit Span and Matrix Reasoning tests of the Wechsler Intelligence Scale for Adults, 3rd edition. The discrepancy between objective and subjective cognition was estimated. Participants were 57 outpatients with MDD. PDQ-D scores were not correlated with composite neurocognitive test (NCT) z scores. Years of education significantly predicted composite NCT z scores, as did age. The 9-item Patient Health Questionnaire (PHQ-9) scores significantly predicted PDQ-D scores, as did antidepressant treatment. Age significantly predicted discrepancy scores, as did PHQ-9 scores. In conclusion, objective and subjective cognition in patients with MDD are not correlated. Age and education predict objective cognition. Depression. severity and antidepressant treatment predict subjective cognition. Age and depression severity may predict the discrepancy between objective and subjective cognition.
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Affiliation(s)
- Manit Srisurapanont
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
| | - Sirijit Suttajit
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Kanokkwan Eurviriyanukul
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Prirada Varnado
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
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McAllister-Williams RH, Bones K, Goodwin GM, Harrison J, Katona C, Rasmussen J, Strong S, Young AH. Analysing UK clinicians' understanding of cognitive symptoms in major depression: A survey of primary care physicians and psychiatrists. J Affect Disord 2017; 207:346-352. [PMID: 27743537 DOI: 10.1016/j.jad.2016.09.036] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 08/16/2016] [Accepted: 09/25/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND Cognitive dysfunction occurs in depression and can persist into remission. It impacts on patient functioning but remains largely unrecognised, unmonitored and untreated. We explored understanding of cognitive dysfunction in depression among UK clinicians. METHODS A multi-step consultation process. Step 1: a multi-stakeholder steering committee identified key themes of burden, detection and management of cognitive dysfunction in depression, and developed statements on each to explore understanding and degree of agreement among clinicians. Step 2: 100 general practitioners (GPs) and 100 psychiatrists indicated their level of agreement with these statements. Step 3: the steering committee reviewed responses and highlighted priority areas for future education and research. RESULTS There was agreement that clinicians are not fully aware of cognitive dysfunction in depression. Views of the relationship between cognitive dysfunction and other depressive symptom severities was not consistent with the literature. In particular, there was a lack of recognition that some cognitive dysfunction can persist into remission. There was understandable uncertainty around treatment options, given the current limited evidence base. However, it was recognised that cognitive dysfunction is an area of unmet need and that there is a lack of objective tests of cognition appropriate for depressed patients that can be easily implemented in the clinic. LIMITATIONS Respondents are likely to be 'led' by the direction of the statements they reviewed. The study did not involve patients and carers. CONCLUSIONS UK clinicians should undergo training regarding cognitive dysfunction in depression, and further research is needed into its assessment, treatment and monitoring.
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Affiliation(s)
| | - Kate Bones
- Sussex Partnership NHS Foundation Trust, Worthing, UK
| | | | - John Harrison
- VU University Medical Center, Amsterdam, The Netherlands
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