Cognitive symptoms in major depressive disorder: associations with clinical and functional outcomes in a 6-month, non-interventional, prospective study in China

Gang Wang,1 Tian-Mei Si,2 Lingjiang Li3,4 Yiru Fang,5 Chun-Xue Wang,6 Li-Na Wang,7 Kristin Hui Xian Tan,8 Anders Ettrup,9 Hanne-Lise Falgreen Eriksen,9 Si Luo,10 Lan Ge101Beijing An Ding Hospital, Capital Medical University, China National Clinical Research Center for Mental Disorders, Beij...

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Autores principales:	Wang G, Si TM, Li L, Fang Y, Wang CX, Wang LN, Tan KHX, Ettrup A, Eriksen HLF, Luo S, Ge L
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	MDD antidepressants cognitive performance real-world evidence PDQ-D DSST Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/ab78cbbbc39a4a8ba3e81ead3e642590
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id	oai:doaj.org-article:ab78cbbbc39a4a8ba3e81ead3e642590
record_format	dspace
institution	DOAJ
collection	DOAJ
language	EN
topic	MDD antidepressants cognitive performance real-world evidence PDQ-D DSST Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	MDD antidepressants cognitive performance real-world evidence PDQ-D DSST Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Wang G Si TM Li L Fang Y Wang CX Wang LN Tan KHX Ettrup A Eriksen HLF Luo S Ge L Cognitive symptoms in major depressive disorder: associations with clinical and functional outcomes in a 6-month, non-interventional, prospective study in China
description	Gang Wang,1 Tian-Mei Si,2 Lingjiang Li3,4 Yiru Fang,5 Chun-Xue Wang,6 Li-Na Wang,7 Kristin Hui Xian Tan,8 Anders Ettrup,9 Hanne-Lise Falgreen Eriksen,9 Si Luo,10 Lan Ge101Beijing An Ding Hospital, Capital Medical University, China National Clinical Research Center for Mental Disorders, Beijing, People’s Republic of China; 2Peking University Sixth Hospital & Peking University Institute of Mental Health, Beijing, 100191, People’s Republic of China; 3Key Laboratory of Mental Health, Ministry of Health (Peking University) &National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, People’s Republic of China; 4The Second Xiangya Hospital of Central South University, Changsha, People’s Republic of China; 5Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China; 6Beijing Tian Tan Hospital, Department of Neuropsychiatry and Behavioral Neurology, Capital Medical University, National Clinical Research Center for Neurological Disease, Beijing, People’s Republic of China; 7Tianjin Anding Hospital, Tianjin, People’s Republic of China; 8Lundbeck Singapore Pte Ltd, Singapore; 9H. Lundbeck A/S, Valby, Denmark; 10Lundbeck China, Beijing, People’s Republic of ChinaObjective: Cognitive symptoms in major depressive disorder (MDD) are common and may negatively impact clinical and functional outcomes. The Prospective Research Observation to Assess Cognition in Treated patients with MDD (PROACT) study aimed to assess the prevalence and course of cognitive symptoms, and their associations with clinical and functional outcomes during 6 months of antidepressant treatment, in a real-world setting among Chinese patients with MDD.Patients and methods: Outpatients (n=598) aged 18–65 years with MDD and a total score ≥17 on the Hamilton Depression Rating Scale – 17 Items (HAM-D17) were observed over 6 months after initiating new antidepressant monotherapy, with follow-up visits at months 1, 2, and 6. Cognitive symptoms were assessed using the Perceived Deficits Questionnaire – Depression (PDQ-D) and cognitive performance using the Digit Symbol Substitution Test (DSST).Results: At baseline, 76.9% of patients had indications of cognitive symptoms (PDQ-D total score ≥21); at month 6, this was reduced, but still present in 32.4%. Across the 6-month study period, patients improved across cognitive, clinical and functional assessments. High levels of cognitive symptoms (PDQ-D) consistently predicted worse clinical outcomes, ie, lower odds for remission and increased odds for relapse, as well as worse patient-reported functional outcomes and lower quality of life. In contrast, cognitive performance (DSST) predicted performance-based functioning but only a few patient-reported functional outcomes (absenteeism and quality of life), and no clinical outcomes. PDQ-D and DSST scores were uncorrelated at baseline.Conclusion: The study highlights the importance of assessing and targeting cognitive symptoms for increasing patients’ chances of recovery and restoring functioning in the treatment of MDD. The results further highlight the relevance of complementary assessment methods to fully capture aspects of cognitive symptoms in patients with depression.Keywords: MDD, antidepressants, cognitive performance, real-world evidence, PDQ-D, DSST
format	article
author	Wang G Si TM Li L Fang Y Wang CX Wang LN Tan KHX Ettrup A Eriksen HLF Luo S Ge L
author_facet	Wang G Si TM Li L Fang Y Wang CX Wang LN Tan KHX Ettrup A Eriksen HLF Luo S Ge L
author_sort	Wang G
title	Cognitive symptoms in major depressive disorder: associations with clinical and functional outcomes in a 6-month, non-interventional, prospective study in China
title_short	Cognitive symptoms in major depressive disorder: associations with clinical and functional outcomes in a 6-month, non-interventional, prospective study in China
title_full	Cognitive symptoms in major depressive disorder: associations with clinical and functional outcomes in a 6-month, non-interventional, prospective study in China
title_fullStr	Cognitive symptoms in major depressive disorder: associations with clinical and functional outcomes in a 6-month, non-interventional, prospective study in China
title_full_unstemmed	Cognitive symptoms in major depressive disorder: associations with clinical and functional outcomes in a 6-month, non-interventional, prospective study in China
title_sort	cognitive symptoms in major depressive disorder: associations with clinical and functional outcomes in a 6-month, non-interventional, prospective study in china
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/ab78cbbbc39a4a8ba3e81ead3e642590
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spelling	oai:doaj.org-article:ab78cbbbc39a4a8ba3e81ead3e6425902021-12-02T09:08:27ZCognitive symptoms in major depressive disorder: associations with clinical and functional outcomes in a 6-month, non-interventional, prospective study in China1178-2021https://doaj.org/article/ab78cbbbc39a4a8ba3e81ead3e6425902019-07-01T00:00:00Zhttps://www.dovepress.com/cognitive-symptoms-in-major-depressive-disorder-associations-with-clin-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Gang Wang,1 Tian-Mei Si,2 Lingjiang Li3,4 Yiru Fang,5 Chun-Xue Wang,6 Li-Na Wang,7 Kristin Hui Xian Tan,8 Anders Ettrup,9 Hanne-Lise Falgreen Eriksen,9 Si Luo,10 Lan Ge101Beijing An Ding Hospital, Capital Medical University, China National Clinical Research Center for Mental Disorders, Beijing, People’s Republic of China; 2Peking University Sixth Hospital & Peking University Institute of Mental Health, Beijing, 100191, People’s Republic of China; 3Key Laboratory of Mental Health, Ministry of Health (Peking University) &National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, People’s Republic of China; 4The Second Xiangya Hospital of Central South University, Changsha, People’s Republic of China; 5Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China; 6Beijing Tian Tan Hospital, Department of Neuropsychiatry and Behavioral Neurology, Capital Medical University, National Clinical Research Center for Neurological Disease, Beijing, People’s Republic of China; 7Tianjin Anding Hospital, Tianjin, People’s Republic of China; 8Lundbeck Singapore Pte Ltd, Singapore; 9H. Lundbeck A/S, Valby, Denmark; 10Lundbeck China, Beijing, People’s Republic of ChinaObjective: Cognitive symptoms in major depressive disorder (MDD) are common and may negatively impact clinical and functional outcomes. The Prospective Research Observation to Assess Cognition in Treated patients with MDD (PROACT) study aimed to assess the prevalence and course of cognitive symptoms, and their associations with clinical and functional outcomes during 6 months of antidepressant treatment, in a real-world setting among Chinese patients with MDD.Patients and methods: Outpatients (n=598) aged 18–65 years with MDD and a total score ≥17 on the Hamilton Depression Rating Scale – 17 Items (HAM-D17) were observed over 6 months after initiating new antidepressant monotherapy, with follow-up visits at months 1, 2, and 6. Cognitive symptoms were assessed using the Perceived Deficits Questionnaire – Depression (PDQ-D) and cognitive performance using the Digit Symbol Substitution Test (DSST).Results: At baseline, 76.9% of patients had indications of cognitive symptoms (PDQ-D total score ≥21); at month 6, this was reduced, but still present in 32.4%. Across the 6-month study period, patients improved across cognitive, clinical and functional assessments. High levels of cognitive symptoms (PDQ-D) consistently predicted worse clinical outcomes, ie, lower odds for remission and increased odds for relapse, as well as worse patient-reported functional outcomes and lower quality of life. In contrast, cognitive performance (DSST) predicted performance-based functioning but only a few patient-reported functional outcomes (absenteeism and quality of life), and no clinical outcomes. PDQ-D and DSST scores were uncorrelated at baseline.Conclusion: The study highlights the importance of assessing and targeting cognitive symptoms for increasing patients’ chances of recovery and restoring functioning in the treatment of MDD. The results further highlight the relevance of complementary assessment methods to fully capture aspects of cognitive symptoms in patients with depression.Keywords: MDD, antidepressants, cognitive performance, real-world evidence, PDQ-D, DSSTWang GSi TMLi LFang YWang CXWang LNTan KHXEttrup AEriksen HLFLuo SGe LDove Medical PressarticleMDDantidepressantscognitive performancereal-world evidencePDQ-DDSSTNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 15, Pp 1723-1736 (2019)

Cognitive symptoms in major depressive disorder: associations with clinical and functional outcomes in a 6-month, non-interventional, prospective study in China

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