Assessing the relationship between functional impairment/recovery and depression severity: a pooled analysis.

Abstract

The objective of this study was to explore the relationship between assessments of functional impairment, emotional well-being, and depression symptoms. Data were pooled from 3530 outpatients with major depressive disorder enrolled in 10 desvenlafaxine clinical trials. The primary outcome measures included (a) the 17-item Hamilton Rating Scale for Depression (HAM-D17) as a measure of depressive symptom severity and (b) the Sheehan Disability Scale (SDS) and five-item World Health Organization Well-Being Index (WHO-5) as measures of functional impairment and well-being. A linear regression model was used to identify the SDS and WHO-5 values that equate to the predetermined clinically relevant three-point difference between active treatment and placebo on the HAM-D17. A receiver operating characteristic analysis was conducted to determine the SDS score that equates to a remission of depression symptoms (i.e. HAM-D17≤7). An approximate three-point difference between active treatment and placebo on the SDS (2.8) and WHO-5 (2.5) was determined to be clinically relevant in relation to improvements in depressive symptoms. An SDS of less than or equal to 7 was equivalent to a remission of depression symptoms, providing a definition of functional remission. A better understanding of the relationship between depressive symptoms and functional impairment and well-being may provide clinicians with a more comprehensive means of assessing treatment effects in major depressive disorder.

• Authors: Christine J Guico-Pabia, Rana S Fayyad, Claudio N Soares
• Journal: International clinical psychopharmacology (Int Clin Psychopharmacol) Vol. 27 Issue 1 Pg. 1-7 (Jan 2012) ISSN: 1473-5857 [Electronic] England
• PMID: 21971533 (Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't)

Chemical References

• Antidepressive Agents
• Cyclohexanols
• Desvenlafaxine Succinate

Topics

• Adult
• Antidepressive Agents (therapeutic use)
• Clinical Trials as Topic
• Cyclohexanols (therapeutic use)
• Depressive Disorder, Major (diagnosis, drug therapy, psychology)
• Desvenlafaxine Succinate
• Disability Evaluation
• Emotions (drug effects)
• Evidence-Based Medicine
• Female
• Humans
• Linear Models
• Logistic Models
• Male
• Middle Aged
• Predictive Value of Tests
• Psychiatric Status Rating Scales
• Recovery of Function
• Remission Induction
• Severity of Illness Index
• Time Factors
• Treatment Outcome