Anhedonia predicts poor psychosocial functioning: Results from a large cohort of patients treated for major depressive disorder by general practitioners

AbstractBackground:Anhedonia is a core symptom of major depression and a key prognostic factor that is often poorly explored in clinical trials of major depressive disorder (MDD). Beyond symptomatic remission, psychosocial functioning also reveals difficulty in achieving remission in patients with MDD. The main objective of this study was to explore the interrelationships between social functioning and anhedonia on a longitudinal basis.Methods:In total, 1570 outpatients treated for MDD with agomelatine were included. Severity of depression and levels of anhedonia and of psychosocial functioning were assessed at inclusion and at 10–14 weeks, with specific standardized scales (MADRS, QFS, SHAPS, CGI). Multivariate regression and mediation analyses were performed.Results:Using multivariate regression, we showed that improvement of anhedonia was the strongest predictor of improvement in psychosocial functioning (odds ratio = 7.3 [4.3–12.1] P < 0.0001). In addition, mediation tests confirmed that the association between improvement of depressive symptoms and improvement of social functioning was significantly underpinned by the improvement of anhedonia over time. Finally, we explored the determinants of the dissociation of the response, i.e., the persistence of psychosocial dysfunctioning despite a symptomatic response to antidepressant treatment, which remains a widespread situation in clinical practice. We showed that this dissociation was strongly predicted by persistence of anhedonia.Conclusion:Our results suggest that anhedonia is one of the strongest predictors of psychosocial functioning, along with symptomatic remission, and should be carefully assessed by health professionals, in order to optimize pharmacological as well as non-pharmacological management of depression.

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Reduced Latency to First Antidepressant Treatment in Italian Patients with a More Recent Onset of Major Depressive Disorder

10.26226/morressier.5885d713d462b8028d891057 ◽

2017 ◽

Author(s):

Benedetta Maria Grancini

Keyword(s):

Major Depressive Disorder ◽

Depressive Disorder ◽

Antidepressant Treatment ◽

Major Depressive ◽

Recent Onset

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Extension Study of Pimavanserin in Subjects With Major Depressive Disorder and Inadequate Response to Antidepressant Treatment

Case Medical Research ◽

10.31525/ct1-nct04000009 ◽

2019 ◽

Author(s):

Keyword(s):

Major Depressive Disorder ◽

Depressive Disorder ◽

Antidepressant Treatment ◽

Extension Study ◽

Inadequate Response ◽

Major Depressive

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Faculty Opinions recommendation of Early prediction of acute antidepressant treatment response and remission in pediatric major depressive disorder.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1160666.622058 ◽

2009 ◽

Author(s):

Charles Zeanah

Keyword(s):

Major Depressive Disorder ◽

Depressive Disorder ◽

Treatment Response ◽

Antidepressant Treatment ◽

Early Prediction ◽

Major Depressive

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Impacts on Quality of Life with Escitalopram Monotherapy and Aripiprazole Augmentation in Patients with Major Depressive Disorder: A CAN-BIND Report

Pharmacopsychiatry ◽

10.1055/a-1385-0263 ◽

2021 ◽

Author(s):

Emma Morton ◽

Venkat Bhat ◽

Peter Giacobbe ◽

Wendy Lou ◽

Erin E. Michalak ◽

...

Keyword(s):

Quality Of Life ◽

Major Depressive Disorder ◽

Depressive Disorder ◽

Repeated Measures ◽

Short Form ◽

Treatment Phase ◽

Major Depressive ◽

Symptomatic Remission ◽

Substantial Degree

Abstract Introduction Many individuals with major depressive disorder (MDD) do not respond to initial antidepressant monotherapy. Adjunctive aripiprazole is recommended for treatment non-response; however, the impacts on quality of life (QoL) for individuals who receive this second-line treatment strategy have not been described. Methods We evaluated secondary QoL outcomes in patients with MDD (n=179). After 8 weeks of escitalopram, non-responders (<50% decrease in clinician-rated depression) were treated with adjunctive aripiprazole for 8 weeks (n=97); responders continued escitalopram (n=82). A repeated-measures ANOVA evaluated change in Quality of Life Enjoyment and Satisfaction Short Form scores. QoL was described relative to normative benchmarks. Results Escitalopram responders experienced the most QoL improvements in the first treatment phase. For non-responders, QoL improved with a large effect during adjunctive aripiprazole treatment. At the endpoint, 47% of patients achieving symptomatic remission still had impaired QoL. Discussion Individuals who were treated with adjunctive aripiprazole after non-response to escitalopram experienced improved QoL, but a substantial degree of QoL impairment persisted. Since QoL deficits may predict MDD recurrence, attention to ways to support this outcome is required.

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Reduced latency to first antidepressant treatment in Italian patients with a more recent onset of major depressive disorder

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.715 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S529-S529

Author(s):

B. Grancini ◽

B. Dell’Osso ◽

L. Cremaschi ◽

F. De Cagna ◽

B. Benatti ◽

...

Keyword(s):

Major Depressive Disorder ◽

Depressive Disorder ◽

Antidepressant Treatment ◽

Stressful Events ◽

Major Depressive ◽

Recent Onset ◽

Valid Predictor ◽

Before And After ◽

Competing Interest ◽

Year 2000

IntroductionMajor depressive disorder (MDD) is a prevalent burdensome disease, which frequently remains untreated. The duration of untreated illness (DUI) is modifiable parameter and a valid predictor of outcome. Previous investigation in patients with MDD revealed a DUI of different years, while recent reports have documented a reduction of DUI across time, in patients with different psychiatric disorders.Objectives/aimsThe present study was aimed to investigate potential differences in terms of DUI and related variables in patients with MDD across time.MethodsAn overall sample of 188 patients with MDD was divided in two subgroups on the basis of their epoch of onset (onset before and after year 2000). DUI and other onset-related variables were assessed through a specific questionnaire and compared between the two subgroups.ResultsThe whole sample showed a mean DUI of approximately 4.5 years, with a lower value in patients with more recent onset compared to the other subgroup (27.1 ± 42.6 vs. 75.8 ± 105.2 months, P < .05). Moreover, patients with onset after 2000 reported higher rates of onset-related stressful events and lower ones for benzodiazepines prescription (65% vs. 81%; P = 0.02; 47% vs. 30%; P = 0.02).ConclusionsThe comparison of groups with different epochs of onset showed a significant reduction in terms of DUI and benzodiazepines prescription, and a higher rate of onset-related stressful events in patients with a more recent onset. Reported findings are of epidemiologic and clinical relevance in order to evaluate progress and developments in the diagnostic and therapeutic pathways of MDD in Italian and other countries.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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