Definition and Identification of Patients with Treatment-Resistant Depression in Real-World Clinical Practice Settings Across Asia
Changsu Han,1 Gang Wang,2 Sandra Chan,3 Tadafumi Kato,4,5 Chee H Ng,6 Wilson Tan,7 Lili Zhang,8 Yu Feng,8 Chia-Yih Liu9 1Department of Psychiatry, Korea University College of Medicine, Seoul, South Korea; 2The National Clinical Research Center for Mental Disorder & Beijing Key Laboratory of...
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Dove Medical Press
2020
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asia treatment-resistant depression diagnosis management Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 |
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asia treatment-resistant depression diagnosis management Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Han C Wang G Chan S Kato T Ng CH Tan W Zhang L Feng Y Liu CY Definition and Identification of Patients with Treatment-Resistant Depression in Real-World Clinical Practice Settings Across Asia |
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Changsu Han,1 Gang Wang,2 Sandra Chan,3 Tadafumi Kato,4,5 Chee H Ng,6 Wilson Tan,7 Lili Zhang,8 Yu Feng,8 Chia-Yih Liu9 1Department of Psychiatry, Korea University College of Medicine, Seoul, South Korea; 2The National Clinical Research Center for Mental Disorder & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital & The Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, People’s Republic of China; 3Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, People’s Republic of China; 4RIKEN Center for Brain Science, Wako, Saitama, Japan; 5Department of Psychiatry and Behavioral Science, Juntendo University Graduate School of Medicine, Tokyo, Japan; 6Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia; 7Regional Medical Affairs, Janssen Pharmaceutical Companies of Johnson and Johnson, Singapore, Singapore; 8Medical Affairs, Xian Janssen Pharmaceutical Ltd, Beijing, People’s Republic of China; 9Department of Psychiatry, Chang Gung Medical Center and Chang Gung University School of Medicine, Taoyuan City, TaiwanCorrespondence: Chia-Yih LiuDepartment of Psychiatry, Chang Gung Medical Center and Chang Gung University School of Medicine, No. 5, Fuching Street, Guishan District, Taoyuan City, TaiwanTel +886-3-3281200 Ext 2439Email liucy752@cgmh.org.twWilson TanRegional Medical Affairs, Janssen Pharmaceutical Companies of Johnson and Johnson, 2 Science Park Drive, #07– 13, Ascent, Singapore Science Park 1, Singapore 118222, SingaporeTel +65-69187930Email wtan27@its.jnj.comPurpose: An Asia-Pacific expert consensus defined treatment-resistant depression (TRD) as failure of ≥ 2 antidepressants given at adequate doses for 6– 8 weeks during a major depressive episode. A survey examined how TRD was being diagnosed in real-world practices across Asia. An expert panel then interpreted the results and provided practical recommendations.Methods: Between March and July 2018, 246 clinicians from Hong Kong, Japan, Mainland China, South Korea, and Taiwan were surveyed on how they identified TRD patients according to their own definitions.Results: Most physicians described antidepressant failure as “no response” (79%) or “inadequate response” (82%); fewer chose “failure to achieve remission” (45%). About 40% did not routinely use clinical tools to assess response. Around 52% defined adequate dose target as achieving the label’s upper dose limit. About 58% would treat for 4– 8 weeks before determining antidepressant failure. Most (76%) required the ≥ 2 qualifying antidepressant failures to be from different classes. Approximately 60% considered antidepressant failure(s) from previous depressive episode(s) when diagnosing TRD.Conclusion: Considering the survey results, antidepressant failure can be defined as a failure to achieve remission, or more practically as < 50% improvement in depressive symptoms or inability to return to work/study, and confirmed with a clinical tool. TRD diagnosis also requires ≥ 2 qualifying antidepressant failures within the same depressive episode; from the same or different classes; and achieving at least the minimum effective antidepressant dose for 6– 8 weeks.Keywords: Asia, treatment-resistant depression, diagnosis, management |
| format |
article |
| author |
Han C Wang G Chan S Kato T Ng CH Tan W Zhang L Feng Y Liu CY |
| author_facet |
Han C Wang G Chan S Kato T Ng CH Tan W Zhang L Feng Y Liu CY |
| author_sort |
Han C |
| title |
Definition and Identification of Patients with Treatment-Resistant Depression in Real-World Clinical Practice Settings Across Asia |
| title_short |
Definition and Identification of Patients with Treatment-Resistant Depression in Real-World Clinical Practice Settings Across Asia |
| title_full |
Definition and Identification of Patients with Treatment-Resistant Depression in Real-World Clinical Practice Settings Across Asia |
| title_fullStr |
Definition and Identification of Patients with Treatment-Resistant Depression in Real-World Clinical Practice Settings Across Asia |
| title_full_unstemmed |
Definition and Identification of Patients with Treatment-Resistant Depression in Real-World Clinical Practice Settings Across Asia |
| title_sort |
definition and identification of patients with treatment-resistant depression in real-world clinical practice settings across asia |
| publisher |
Dove Medical Press |
| publishDate |
2020 |
| url |
https://doaj.org/article/b835f1625a9749cfa77d2ea87ec05533 |
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oai:doaj.org-article:b835f1625a9749cfa77d2ea87ec055332021-12-02T15:16:28ZDefinition and Identification of Patients with Treatment-Resistant Depression in Real-World Clinical Practice Settings Across Asia1178-2021https://doaj.org/article/b835f1625a9749cfa77d2ea87ec055332020-12-01T00:00:00Zhttps://www.dovepress.com/definition-and-identification-of-patients-with-treatment-resistant-dep-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Changsu Han,1 Gang Wang,2 Sandra Chan,3 Tadafumi Kato,4,5 Chee H Ng,6 Wilson Tan,7 Lili Zhang,8 Yu Feng,8 Chia-Yih Liu9 1Department of Psychiatry, Korea University College of Medicine, Seoul, South Korea; 2The National Clinical Research Center for Mental Disorder & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital & The Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, People’s Republic of China; 3Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, People’s Republic of China; 4RIKEN Center for Brain Science, Wako, Saitama, Japan; 5Department of Psychiatry and Behavioral Science, Juntendo University Graduate School of Medicine, Tokyo, Japan; 6Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia; 7Regional Medical Affairs, Janssen Pharmaceutical Companies of Johnson and Johnson, Singapore, Singapore; 8Medical Affairs, Xian Janssen Pharmaceutical Ltd, Beijing, People’s Republic of China; 9Department of Psychiatry, Chang Gung Medical Center and Chang Gung University School of Medicine, Taoyuan City, TaiwanCorrespondence: Chia-Yih LiuDepartment of Psychiatry, Chang Gung Medical Center and Chang Gung University School of Medicine, No. 5, Fuching Street, Guishan District, Taoyuan City, TaiwanTel +886-3-3281200 Ext 2439Email liucy752@cgmh.org.twWilson TanRegional Medical Affairs, Janssen Pharmaceutical Companies of Johnson and Johnson, 2 Science Park Drive, #07– 13, Ascent, Singapore Science Park 1, Singapore 118222, SingaporeTel +65-69187930Email wtan27@its.jnj.comPurpose: An Asia-Pacific expert consensus defined treatment-resistant depression (TRD) as failure of ≥ 2 antidepressants given at adequate doses for 6– 8 weeks during a major depressive episode. A survey examined how TRD was being diagnosed in real-world practices across Asia. An expert panel then interpreted the results and provided practical recommendations.Methods: Between March and July 2018, 246 clinicians from Hong Kong, Japan, Mainland China, South Korea, and Taiwan were surveyed on how they identified TRD patients according to their own definitions.Results: Most physicians described antidepressant failure as “no response” (79%) or “inadequate response” (82%); fewer chose “failure to achieve remission” (45%). About 40% did not routinely use clinical tools to assess response. Around 52% defined adequate dose target as achieving the label’s upper dose limit. About 58% would treat for 4– 8 weeks before determining antidepressant failure. Most (76%) required the ≥ 2 qualifying antidepressant failures to be from different classes. Approximately 60% considered antidepressant failure(s) from previous depressive episode(s) when diagnosing TRD.Conclusion: Considering the survey results, antidepressant failure can be defined as a failure to achieve remission, or more practically as < 50% improvement in depressive symptoms or inability to return to work/study, and confirmed with a clinical tool. TRD diagnosis also requires ≥ 2 qualifying antidepressant failures within the same depressive episode; from the same or different classes; and achieving at least the minimum effective antidepressant dose for 6– 8 weeks.Keywords: Asia, treatment-resistant depression, diagnosis, managementHan CWang GChan SKato TNg CHTan WZhang LFeng YLiu CYDove Medical Pressarticleasiatreatment-resistant depressiondiagnosismanagementNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 16, Pp 2929-2941 (2020) |