Daily activity level improvement with antidepressant medications predicts long-term clinical outcomes in outpatients with major depressive disorder

Manish K Jha,1 Raymond B Teer,2 Abu Minhajuddin,3 Tracy L Greer,1 A John Rush,4 Madhukar H Trivedi1 1Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, 2University of Texas, Austin, 3Department of Clinical Sciences, University of Texas Southwe...

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Autores principales:	Jha MK, Teer RB, Minhajuddin A, Greer TL, Rush AJ, Trivedi MH
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2017
Materias:	Depression Activity Impairment Antidepressant Predictors Functional Recovery Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/aaac2b3e51e142b9982043367b32100d
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spelling	oai:doaj.org-article:aaac2b3e51e142b9982043367b32100d2021-12-02T05:18:42ZDaily activity level improvement with antidepressant medications predicts long-term clinical outcomes in outpatients with major depressive disorder1178-2021https://doaj.org/article/aaac2b3e51e142b9982043367b32100d2017-03-01T00:00:00Zhttps://www.dovepress.com/daily-activity-level-improvement-with-antidepressant-medications-predi-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Manish K Jha,1 Raymond B Teer,2 Abu Minhajuddin,3 Tracy L Greer,1 A John Rush,4 Madhukar H Trivedi1 1Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, 2University of Texas, Austin, 3Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA; 4Duke-NUS, Singapore, Singapore Background: Major depressive disorder (MDD) significantly impacts performance of both work- and nonwork-related routine daily activities. We have shown that work productivity is significantly impaired in employed MDD patients, but the extent of impairments in nonwork-related routine activities and its association with antidepressant treatment outcomes has not been established. Materials and methods: Activity impairment was measured using the sixth item of Work Productivity and Activity Impairment Scale in the Combining Medications to Enhance Depression Outcomes (CO-MED) trial (n=665). Published norms were used to define activity impairment levels. The relationship between activity impairment and baseline sociodemographic and clinical characteristics was evaluated along with changes in activity impairment and its relationship with other clinical outcomes such as symptom severity, function, and side effect burden. Remission status at 3 and 7 months was predicted based on week 6 activity impairment level. Results: Higher psychosocial and cognitive impairments and greater number of comorbid medical conditions were associated with greater activity impairment at baseline. Proportion of participants with severe activity impairment declined from 47.6% at baseline to 18.7% at 3 months, while mean activity impairment decreased from 57.1 at baseline to 32.8 at 3 months. During course of treatment, levels of activity impairment correlated most strongly with psychosocial function among measures of symptom severity, function, quality of life, and side effect burden. No or minimal activity impairment at week 6 was associated with two to three times higher rates of remission at 3 and 7 months as compared to moderate or severe activity impairment levels even after controlling for remission status at week 6 and select baseline variables. Conclusion: Depressed patients have high levels of nonwork-related activity impairment at baseline that improves significantly with treatment and independently predicts long-term clinical outcomes. Brief systematic assessment of activity impairment during the course of antidepressant treatment can help inform clinical decision-making. Keywords: depression, activity impairment, predictors, functional recovery, productivityJha MKTeer RBMinhajuddin AGreer TLRush AJTrivedi MHDove Medical PressarticleDepressionActivity ImpairmentAntidepressantPredictorsFunctional RecoveryNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 13, Pp 803-813 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Depression Activity Impairment Antidepressant Predictors Functional Recovery Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	Depression Activity Impairment Antidepressant Predictors Functional Recovery Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Jha MK Teer RB Minhajuddin A Greer TL Rush AJ Trivedi MH Daily activity level improvement with antidepressant medications predicts long-term clinical outcomes in outpatients with major depressive disorder
description	Manish K Jha,1 Raymond B Teer,2 Abu Minhajuddin,3 Tracy L Greer,1 A John Rush,4 Madhukar H Trivedi1 1Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, 2University of Texas, Austin, 3Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA; 4Duke-NUS, Singapore, Singapore Background: Major depressive disorder (MDD) significantly impacts performance of both work- and nonwork-related routine daily activities. We have shown that work productivity is significantly impaired in employed MDD patients, but the extent of impairments in nonwork-related routine activities and its association with antidepressant treatment outcomes has not been established. Materials and methods: Activity impairment was measured using the sixth item of Work Productivity and Activity Impairment Scale in the Combining Medications to Enhance Depression Outcomes (CO-MED) trial (n=665). Published norms were used to define activity impairment levels. The relationship between activity impairment and baseline sociodemographic and clinical characteristics was evaluated along with changes in activity impairment and its relationship with other clinical outcomes such as symptom severity, function, and side effect burden. Remission status at 3 and 7 months was predicted based on week 6 activity impairment level. Results: Higher psychosocial and cognitive impairments and greater number of comorbid medical conditions were associated with greater activity impairment at baseline. Proportion of participants with severe activity impairment declined from 47.6% at baseline to 18.7% at 3 months, while mean activity impairment decreased from 57.1 at baseline to 32.8 at 3 months. During course of treatment, levels of activity impairment correlated most strongly with psychosocial function among measures of symptom severity, function, quality of life, and side effect burden. No or minimal activity impairment at week 6 was associated with two to three times higher rates of remission at 3 and 7 months as compared to moderate or severe activity impairment levels even after controlling for remission status at week 6 and select baseline variables. Conclusion: Depressed patients have high levels of nonwork-related activity impairment at baseline that improves significantly with treatment and independently predicts long-term clinical outcomes. Brief systematic assessment of activity impairment during the course of antidepressant treatment can help inform clinical decision-making. Keywords: depression, activity impairment, predictors, functional recovery, productivity
format	article
author	Jha MK Teer RB Minhajuddin A Greer TL Rush AJ Trivedi MH
author_facet	Jha MK Teer RB Minhajuddin A Greer TL Rush AJ Trivedi MH
author_sort	Jha MK
title	Daily activity level improvement with antidepressant medications predicts long-term clinical outcomes in outpatients with major depressive disorder
title_short	Daily activity level improvement with antidepressant medications predicts long-term clinical outcomes in outpatients with major depressive disorder
title_full	Daily activity level improvement with antidepressant medications predicts long-term clinical outcomes in outpatients with major depressive disorder
title_fullStr	Daily activity level improvement with antidepressant medications predicts long-term clinical outcomes in outpatients with major depressive disorder
title_full_unstemmed	Daily activity level improvement with antidepressant medications predicts long-term clinical outcomes in outpatients with major depressive disorder
title_sort	daily activity level improvement with antidepressant medications predicts long-term clinical outcomes in outpatients with major depressive disorder
publisher	Dove Medical Press
publishDate	2017
url	https://doaj.org/article/aaac2b3e51e142b9982043367b32100d
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Daily activity level improvement with antidepressant medications predicts long-term clinical outcomes in outpatients with major depressive disorder

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