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Barbalat G, Tanguy Melac A, Zante E, Haesebaert F, Franck N. Predictors of mental well-being over the first lockdown period due to the COVID-19 pandemic in France. A repeated cross-sectional study. Front Public Health 2023; 11:1234023. [PMID: 37701911 PMCID: PMC10493269 DOI: 10.3389/fpubh.2023.1234023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 08/07/2023] [Indexed: 09/14/2023] Open
Abstract
Introduction Numerous studies have investigated the positive and negative effects of potential predictors of well-being during lockdowns due to COVID-19. Yet, little is known on whether these effects significantly changed with time spent in lockdown. In the current study, we described the association of mental well-being with a large number of background characteristics (e.g., socio-demographic or health-related factors), COVID-related factors, and coping strategies, over the duration of the first lockdown due to COVID-19 in France. Methods A nationwide online survey was conducted over 7 of the 8 weeks of the 1st lockdown in France, i.e., from 25 March 2020 to 10 May 2020. The level of mental well-being was reported using the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS). We also measured various background characteristics (e.g., age, sex, education, health issues), COVID-related factors (e.g., health and economic risks, agreement with lockdown), and coping strategies. Our analytical strategy enabled us to disentangle effects aggregated over the study period from those that linearly vary with time spent in lockdown. Results Our final dataset included 18,957 participants. The level of mental well-being dropped gradually from the third to the eighth week of lockdown [49.7 (sd 7.9) to 45.5 (sd 10.6)]. Time in lockdown was associated with a decrease in well-being (for each additional 10 days of lockdown: B = -0.30, 95%CI: -0.62, -0.15). Factors that showed significantly negative and positive effects on well-being as time in lockdown progressed were (for each additional 10 days of lockdown): having current psychiatric problems (B = -0.37; 95%CI: -0.63, -0.04), worries about having access to personal protective equipment (B = -0.09; 95%CI: -0.18, -0.01), coping by having positive beliefs about the future of the pandemics (B = 0.29; 95%CI: 0.04, 0.62), being supported by neighbors (B = 0.24; 95%CI: 0.04, 0.44), and being involved in collective actions (B = 0.23; 95%CI: 0.04, 0.46). Discussion Participants from our sample saw a drop in their mental well-being throughout the first period of COVID-19 lockdown. Policymakers should be mindful of factors contributing to greater deterioration of mental well-being over time, such as having current psychiatric issues. Promoting collective actions and local support from neighbors may alleviate the deterioration of mental well-being over time.
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Affiliation(s)
- Guillaume Barbalat
- Centre Ressource de Réhabilitation Psychosociale, Centre hospitalier Le Vinatier, Bron, France
- UMR 5229, CNRS and Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
- Pôle Centre rive gauche, Centre hospitalier Le Vinatier, Bron, France
| | | | - Elodie Zante
- Centre Ressource de Réhabilitation Psychosociale, Centre hospitalier Le Vinatier, Bron, France
| | - Frédéric Haesebaert
- Centre Ressource de Réhabilitation Psychosociale, Centre hospitalier Le Vinatier, Bron, France
- PSYR2, INSERM U1028, CNRS UMR 5292, CRNL, Université de Lyon, UCBL, Lyon, France
| | - Nicolas Franck
- Centre Ressource de Réhabilitation Psychosociale, Centre hospitalier Le Vinatier, Bron, France
- UMR 5229, CNRS and Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
- Pôle Centre rive gauche, Centre hospitalier Le Vinatier, Bron, France
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Melac AT, Lesuffleur T, Bousquet PJ, Fagot-Campagna A, Gastaldi-Ménager C, Tuppin P. Cancer and end of life: the management provided during the year and the month preceding death in 2015 and causes of death in France. Support Care Cancer 2019; 28:3877-3887. [PMID: 31845006 DOI: 10.1007/s00520-019-05188-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 11/07/2019] [Indexed: 12/01/2022]
Abstract
PURPOSE The management of cancer patients at the end of life in France and their causes of death are not well known. METHODS People managed for cancer in 2014-2015, who died in 2015 and who were covered by the national health insurance general scheme (77% of the French population) were selected from the national health data system in order to analyze the health care reimbursed during the year and the month before their death. RESULTS This study included 125,497 people (mean age 73 years, SD 12.5) managed for cancer: colorectal: 12%, lung: 18%, prostate: 9%, breast: 8% and other: 62%. Almost 67% of people died in short-stay hospitals (SSH), 8% died in rehabilitation units (Rehab), 4% died in hospital at home (HaH), 5% died in skilled nursing homes (SNH) and 15% died at home or another place. The mean annual duration of all types of hospitalization was 70 days (SD 66) and 59% of patients had received hospital palliative care (HPC). During the last month of life, 42% of people had attended an emergency department at least once and people who had received HPC were less often admitted to an intensive care unit (10% versus 23%, 15% overall). During the month before death, 17% of patients had received intravenous chemotherapy (lung 23%, breast 21%) and 9% had received a pharmacy reimbursement for another form of chemotherapy (prostate 24%, breast 19%). The main cause of death was a tumour for 81% of patients: after management of lung cancer in 91% of cases, breast cancer in 81% of cases, colorectal cancer in 76% of cases and prostate cancer in 63% of cases. CONCLUSIONS Cancer management and death mostly occurred in SSH in France. Cancer patients frequently attend the emergency department and frequently receive chemotherapy during the last month of life. These data continue to contrast with those observed in Scandinavian- and English-speaking countries, in which management of the end of life at home is preferred.
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Affiliation(s)
- Audrey Tanguy Melac
- Direction de la Stratégie des Études et des Statistiques, Caisse Nationale d'Assurance Maladie (Cnam), 26-50, avenue du Professeur André Lemierre, F-75986, Paris Cedex 20, France
| | - Thomas Lesuffleur
- Direction de la Stratégie des Études et des Statistiques, Caisse Nationale d'Assurance Maladie (Cnam), 26-50, avenue du Professeur André Lemierre, F-75986, Paris Cedex 20, France
| | | | - Anne Fagot-Campagna
- Direction de la Stratégie des Études et des Statistiques, Caisse Nationale d'Assurance Maladie (Cnam), 26-50, avenue du Professeur André Lemierre, F-75986, Paris Cedex 20, France
| | - Christelle Gastaldi-Ménager
- Direction de la Stratégie des Études et des Statistiques, Caisse Nationale d'Assurance Maladie (Cnam), 26-50, avenue du Professeur André Lemierre, F-75986, Paris Cedex 20, France
| | - Philippe Tuppin
- Direction de la Stratégie des Études et des Statistiques, Caisse Nationale d'Assurance Maladie (Cnam), 26-50, avenue du Professeur André Lemierre, F-75986, Paris Cedex 20, France.
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Jacobi H, du Montcel ST, Bauer P, Giunti P, Cook A, Labrum R, Parkinson MH, Durr A, Brice A, Charles P, Marelli C, Mariotti C, Nanetti L, Sarro L, Rakowicz M, Sulek A, Sobanska A, Schmitz-Hübsch T, Schöls L, Hengel H, Baliko L, Melegh B, Filla A, Antenora A, Infante J, Berciano J, van de Warrenburg BP, Timmann D, Szymanski S, Boesch S, Nachbauer W, Kang JS, Pandolfo M, Schulz JB, Melac AT, Diallo A, Klockgether T. Long-term evolution of patient-reported outcome measures in spinocerebellar ataxias. J Neurol 2018; 265:2040-2051. [PMID: 29959555 DOI: 10.1007/s00415-018-8954-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 06/19/2018] [Accepted: 06/20/2018] [Indexed: 11/24/2022]
Abstract
INTRODUCTION To study the long-term evolution of patient-reported outcome measures (PROMs) in the most common spinocerebellar ataxias (SCAs), we analyzed 8 years follow-up data of the EUROSCA Natural History Study, a cohort study of 526 patients with SCA1, SCA2, SCA3 and SCA6. METHODS To assess the functional capacity in daily living, we used the functional assessment (part IV) of the Unified Huntington's Disease Rating Scale (UHDRS-IV), for health-related quality of life the visual analogue scale of the EuroQol Five Dimensions Questionnaire (EQ-5D VAS), and for depressive symptoms the Patient Health Questionnaire (PHQ-9). Severity of ataxia was assessed using the Scale for the Assessment and Rating of Ataxia (SARA) and neurological symptoms other than ataxia with the Inventory of Non-Ataxia Signs (INAS). RESULTS UHDRS-IV [SCA1: - 1.35 (0.12); SCA2: - 1.15 (0.11); SCA3: - 1.16 (0.11); SCA6: - 0.99 (0.12)] and EQ-5D [SCA1: - 2.88 (0.72); SCA2: - 1.97 (0.49); SCA3: - 2.06 (0.55); SCA6: - 1.03 (0.57)] decreased linearly, whereas PHQ-9 increased [SCA1: 0.15 (0.04); SCA2: 0.09 (0.03); SCA3: 0.06 (0.04); SCA6: 0.07 (0.04)] during the observational period. Standard response means (SRMs) of UHDRS-IV (0.473-0.707) and EQ-5D VAS (0.053-0.184) were lower than that of SARA (0.404-0.979). In SCA1, higher SARA scores [- 0.0288 (0.01), p = 0.0251], longer repeat expansions [- 0.0622 (0.02), p = 0.0002] and the presence of cognitive impairment at baseline [- 0.5381 (0.25), p = 0.0365] were associated with faster UHDRS-IV decline. In SCA3, higher INAS counts were associated with a faster UHDRS-IV decline [- 0.05 (0.02), p = 0.0212]. In SCA1, PHQ-9 progression was faster in patients with cognitive impairment [0.14 (0.07); p = 0.0396]. CONCLUSIONS In the common SCAs, PROMs give complementary information to the information provided by neurological scales. This underlines the importance of PROMs as additional outcome measures in future interventional trials.
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Affiliation(s)
- Heike Jacobi
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany. .,Department of Neurology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
| | - Sophie Tezenas du Montcel
- Sorbonne Universités, Université Pierre et Marie Curie (UPMC) Univ Paris 06, UMRS 1136, INSERM U 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, 75013, Paris, France.,AP-HP, Biostatistics Unit, Groupe Hospitalier Pitié-Salpêtrière, 75013, Paris, France
| | - Peter Bauer
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany.,CENTOGENE AG, Rostock, Germany
| | - Paola Giunti
- Department of Molecular Neuroscience, UCL, Institute of Neurology, London, UK
| | - Arron Cook
- Department of Molecular Neuroscience, UCL, Institute of Neurology, London, UK
| | - Robyn Labrum
- Neurogenetic Laboratory, National Hospital of Neurology and Neurosurgery, UCL, London, UK
| | - Michael H Parkinson
- Department of Molecular Neuroscience, UCL, Institute of Neurology, London, UK
| | - Alexandra Durr
- INSERM, U 1127, 75013, Paris, France.,CNRS, UMR 7225, 75013, Paris, France.,Sorbonne Universités, UPMC Univ Paris 06, UMRS_1127, 75013, Paris, France.,Institut du Cerveau et de la Moelle épinière, ICM, 75013, Paris, France.,Département de Génétique, APHP, Hôpital de la Pitié-Salpêtrière, 75013, Paris, France
| | - Alexis Brice
- INSERM, U 1127, 75013, Paris, France.,CNRS, UMR 7225, 75013, Paris, France.,Sorbonne Universités, UPMC Univ Paris 06, UMRS_1127, 75013, Paris, France.,Institut du Cerveau et de la Moelle épinière, ICM, 75013, Paris, France.,Département de Génétique, APHP, Hôpital de la Pitié-Salpêtrière, 75013, Paris, France
| | - Perrine Charles
- Département de Génétique, APHP, Hôpital de la Pitié-Salpêtrière, 75013, Paris, France
| | - Cecilia Marelli
- Service de Neurologie-CMRR, CHRU Gui de Chauliac, 80, av. A. Fliche, 34295, Montpellier Cedex 05, France
| | - Caterina Mariotti
- SOSD Genetics of Neurodegenerative and Metabolic Diseases, Fondazione-IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Lorenzo Nanetti
- SOSD Genetics of Neurodegenerative and Metabolic Diseases, Fondazione-IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Lidia Sarro
- SOSD Genetics of Neurodegenerative and Metabolic Diseases, Fondazione-IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Maria Rakowicz
- Department of Clinical Neurophysiology, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Anna Sulek
- Department of Genetics, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Anna Sobanska
- Department of Clinical Neurophysiology, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Tanja Schmitz-Hübsch
- Charité Universitätsmedizin Berlin, NeuroCure Clinical Research Center, Berlin, Germany
| | - Ludger Schöls
- Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen and Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), 72076, Tübingen, Germany
| | - Holger Hengel
- Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen and Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), 72076, Tübingen, Germany
| | - Laszlo Baliko
- Department of Neurology, Zala County Hospital, Zrinyi M. Str. 1, Zalaegerszeg, 8900, Hungary
| | - Bela Melegh
- Department of Medical Genetics, Medical School, and Szentagothai Research Center, University of Pécs, Pécs, Hungary
| | - Alessandro Filla
- Department of Neuroscience, and Reproductive and Odontostomatological Sciences, Federico II University Naples, Naples, Italy
| | - Antonella Antenora
- Department of Neuroscience, and Reproductive and Odontostomatological Sciences, Federico II University Naples, Naples, Italy
| | - Jon Infante
- Service of Neurology, University Hospital Marqués de Valdecilla (IDIVAL), University of Cantabria (UC) and Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Santander, Spain
| | - José Berciano
- Service of Neurology, University Hospital "Marqués de Valdecilla (IDIVAL)", "Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED)", University of Cantabria (UC), Santander, Spain
| | - Bart P van de Warrenburg
- Department of Neurology, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Dagmar Timmann
- Department of Neurology, University Clinic Essen, University of Duisburg-Essen, Essen, Germany
| | - Sandra Szymanski
- Department of Neurology, St. Josef Hospital, University Hospital of Bochum, Bochum, Germany
| | - Sylvia Boesch
- Department of Neurology, Medical University, Innsbruck, Innsbruck, Austria
| | - Wolfgang Nachbauer
- Department of Neurology, Medical University, Innsbruck, Innsbruck, Austria
| | - Jun-Suk Kang
- Department of Neurology, University of Frankfurt, Frankfurt am Main, Germany
| | - Massimo Pandolfo
- Université Libre de Bruxelles (ULB), Neurology Service-ULB Hôpital Erasme, ULB Laboratory of Experimental Neurology, Brussels, Belgium
| | - Jörg B Schulz
- Department of Neurology, RWTH Aachen University, Pauwelsstraβe 30, 52074, Aachen, Germany.,JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, 52074, Aachen, Germany
| | - Audrey Tanguy Melac
- AP-HP, Biostatistics Unit, Groupe Hospitalier Pitié-Salpêtrière, 75013, Paris, France
| | - Alhassane Diallo
- Sorbonne Universités, Université Pierre et Marie Curie (UPMC) Univ Paris 06, UMRS 1136, INSERM U 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, 75013, Paris, France
| | - Thomas Klockgether
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.,Department of Neurology, University Hospital of Bonn, Bonn, Germany
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Tanguy Melac A, Mariotti C, Filipovic Pierucci A, Giunti P, Arpa J, Boesch S, Klopstock T, Müller Vom Hagen J, Klockgether T, Bürk K, Schulz JB, Reetz K, Pandolfo M, Durr A, Tezenas du Montcel S. Friedreich and dominant ataxias: quantitative differences in cerebellar dysfunction measurements. J Neurol Neurosurg Psychiatry 2018; 89:559-565. [PMID: 29279305 DOI: 10.1136/jnnp-2017-316964] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 11/11/2017] [Accepted: 11/19/2017] [Indexed: 11/04/2022]
Abstract
BACKGROUND Sensitive outcome measures for clinical trials on cerebellar ataxias are lacking. Most cerebellar ataxias progress very slowly and quantitative measurements are required to evaluate cerebellar dysfunction. METHODS We evaluated two scales for rating cerebellar ataxias: the Composite Cerebellar Functional Severity (CCFS) Scale and Scale for the Assessment and Rating of Ataxia (SARA), in patients with spinocerebellar ataxia (SCA) and controls. We evaluated these scales for different diseases and investigated the factors governing the scores obtained. All patients were recruited prospectively. RESULTS There were 383 patients with Friedreich's ataxia (FRDA), 205 patients with SCA and 168 controls. In FRDA, 31% of the variance of cerebellar signs with the CCFS and 41% of that with SARA were explained by disease duration, age at onset and the shorter abnormal repeat in the FXN gene. Increases in CCFS and SARA scores per year were lower for FRDA than for SCA (CCFS index: 0.123±0.123 per year vs 0.163±0.179, P<0.001; SARA index: 1.5±1.2 vs 1.7±1.7, P<0.001), indicating slower cerebellar dysfunction indexes for FRDA than for SCA. Patients with SCA2 had higher CCFS scores than patients with SCA1 and SCA3, but similar SARA scores. CONCLUSIONS Cerebellar dysfunction, as measured with the CCFS and SARA scales, was more severe in FRDA than in patients with SCA, but with lower progression indexes, within the limits of these types of indexes. Ceiling effects may occur at late stages, for both scales. The CCFS scale is rater-independent and could be used in a multicentre context, as it is simple, rapid and fully automated. TRIAL REGISTRATION NUMBER ClinicalTrials.gov: NCT02069509.
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Affiliation(s)
- Audrey Tanguy Melac
- Department of Biostatistics and Medical Informatics, AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles-Foix, Paris, France
| | - Caterina Mariotti
- Unit of Genetics of Neurodegenerative and Metabolic Diseases, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Neurologico Carlo Besta, Milano, Italy
| | | | - Paola Giunti
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
| | - Javier Arpa
- Department of Neurology, Instituto de Investigación Hospital Universitario La Paz, Madrid, Spain
| | - Sylvia Boesch
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Thomas Klopstock
- Department of Neurology, Friedrich-Baur-Institute, University of Munich, Munich, Germany.,German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Jennifer Müller Vom Hagen
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, Tuebingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Thomas Klockgether
- Department of Neurology, University of Bonn, Bonn, Germany.,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Katrin Bürk
- Department of Neurology, Philipps Universität Marburg, Marburg, Germany.,Paracelsus-Elena-Klinik, Kassel, Germany
| | - Jörg B Schulz
- Department of Neurology, Center for Rare Diseases, Clinical Trial Centre, JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, Aachen, Germany
| | - Kathrin Reetz
- Department of Neurology, Center for Rare Diseases, Clinical Trial Centre, JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, Aachen, Germany
| | | | - Alexandra Durr
- Department of Genetics, ICM Institut du Cerveau et de la Moelle and APHP, University Hospital Pitié-Salpêtrière, Paris, France
| | - Sophie Tezenas du Montcel
- Department of Biostatistics and Medical Informatics, AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles-Foix, Paris, France.,Sorbonne Universités, UPMC Univ Paris 06 UMR_S1136, Paris, France.,INSERM UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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