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BMC Psychiatry
Published in: BMC Psychiatry 1/2018

Open Access 01-12-2018 | Research article

Humanistic outcomes in treatment resistant depression: a secondary analysis of the STAR*D study

Authors: Allitia DiBernardo, Xiwu Lin, Qiaoyi Zhang, Jim Xiang, Lang Lu, Carol Jamieson, Carmela Benson, Kwan Lee, Robert Bodén, Lena Brandt, Philip Brenner, Johan Reutfors, Gang Li

Published in: BMC Psychiatry | Issue 1/2018

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Abstract

Background

In the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study, a third of patients did not achieve remission or adequate response after two treatment trials, fulfilling requirements for treatment resistant depression (TRD). The present study is a secondary analysis of the STAR*D data conducted to compare the humanistic outcomes in patients with TRD and non-TRD MDD.

Methods

Patients with major depressive disorder who entered level 3 of the STAR*D were included in the TRD group, while patients who responded to treatment and entered follow-up from level 1 or 2 were included in the non-TRD group. The first visit in level 1 was used for baseline assessments. The time-point of assessments for comparison was the first visit in level 3 for TRD patients (median day: 141), and the visit closest to 141 ± 60 days from baseline for non-TRD patients. Outcomes were assessed by the 12-item Short Form Health Survey (SF12), 16-item Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q), Work and Social Adjustment Scale (WSAS), and Work Productivity and Activity Impairment scale (WPAI). Scores were compared in a linear model with adjustment for covariates including age, gender, and depression severity measured by the 17-item Hamilton Rating Scale for Depression (HDRS17) and Quick Inventory of Depressive Symptomatology (QIDS).

Results

A total of 2467 (TRD: 377; non-TRD: 2090) patients were studied. TRD patients were slightly older (mean age 44 vs 42 years), had a higher proportion of men (49% vs 37%, p < .0001), and baseline depression severity (HDRS17: 24.4 vs 22.0, p < .0001) vs non-TRD patients. During follow-up, TRD patients had lower health-related quality of life (HRQOL) scores on mental (30 vs 45.7) and physical components (47.7 vs 48.9) of the SF12, and lower Q-LES-Q scores (43.6 vs 63.7), greater functional and work impairments and productivity loss vs non-TRD patients (all p < 0.05).

Conclusion

Patients with TRD had worse HRQOL, work productivity, and social functioning than the non-TRD patients.
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Metadata
Title
Humanistic outcomes in treatment resistant depression: a secondary analysis of the STAR*D study
Authors
Allitia DiBernardo
Xiwu Lin
Qiaoyi Zhang
Jim Xiang
Lang Lu
Carol Jamieson
Carmela Benson
Kwan Lee
Robert Bodén
Lena Brandt
Philip Brenner
Johan Reutfors
Gang Li
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2018
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-018-1920-7

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