scholarly journals PS75. Psychopharmacoepidemiology of Major Depressive Disorder in European Tertiary Psychiatric Treatment Centers

2016 ◽  
Vol 19 (Suppl_1) ◽  
pp. 25-26
2017 ◽  
Vol 41 (S1) ◽  
pp. s242-s242
Author(s):  
K. Musliner ◽  
T. Laursen ◽  
T. Munk-Olsen ◽  
X. Liu ◽  
P. Mortensen ◽  
...  

ObjectivesTo examine 5 years trajectories of secondary-treated late-life major depressive disorder (MDD), and evaluate whether pre-existing cerebrovascular disease and related risk factors are associated with more severe trajectories of late-life MDD.MethodsData were obtained from Danish registers. The sample included 11,184 adults ≥ 60 at index MDD diagnosis. Trajectories of in or outpatient contact at psychiatric hospitals for MDD over the 5 years period following index MDD diagnosis were modeled using latent class growth analysis. Risk factors included cerebrovascular disease, cardiovascular disease, hypertension, diabetes, and vascular dementia defined based on hospital diagnoses and prescription medications, demographic characteristics and characteristics of the index MDD diagnosis.ResultsThe final model included classes with consistently low (66%), high decreasing (19%), consistently high (9%) and moderate fluctuating (6%) probabilities of contact at a psychiatric hospital for MDD during the 5 year period following the index MDD diagnosis (Fig. 1). Older age, greater severity, inpatient treatment and > 12 antidepressant prescriptions within 5 years of the index MDD diagnosis predicted membership in more severe trajectory classes. Cerebrovascular disease and related risk factors were not associated with trajectory class membership.ConclusionsA substantial proportion (34%) of individuals diagnosed with MDD in late-life require specialized psychiatric treatment for extended periods of time. We found no evidence that cerebrovascular disease or related risk factors predicted course trajectories in secondary-treated late-life MDD.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2020 ◽  
Author(s):  
Shusuke Numata ◽  
Masahito Nakataki ◽  
Naomi Hasegawa ◽  
Yoshikazu Takaesu ◽  
Masahiro Takeshima ◽  
...  

Abstract Background: To implement clinical practice guidelines (CPGs), it is necessary for psychiatrists to deepen their understanding of existing CPGs. The Effectiveness of Guidelines for Dissemination and Education in Psychiatric Treatment (EGUIDE) project is a nationwide dissemination and implementation study of two sets of CPGs, including one for schizophrenia and one for major depressive disorder (MDD).Methods: A total of 413 psychiatrists (n=212 in 2016; n=201 in 2017) learned the two CPGs in the education program of the EGUIDE project over two days, and clinical knowledge of the two CPGs was evaluated by two 37-item questionnaires at baseline and after the EGUIDE programs. To improve the correct answer rate for clinical knowledge after the EGUIDE programs, we revised the lecture materials associated with items that had a low correct answer rate in 2016 and used the revised lecture materials with the CPGs in 2017. The rates of correct answers for each item after the EGUIDE programs were compared between the 2016 and 2017 groups.Results: The total clinical knowledge scores significantly increased after the EGUIDE program in both the 2016 groups and the 2017 groups. We revised lecture materials related to two items in the schizophrenia CPG and five items in the MDD CPG that had low correct answer rates after the EGUIDE programs. The correct answer rate of one item on the schizophrenia CPG and one item on the MDD CPG were increased (S-D5, p=0.038; D-C6, p=0.033) and that of one item on the MDD CPG was significantly improved (D-D3, p=0.00080) in the 2017 group compared to the rates of the 2016 group. The correct response rates of the other four items were not significantly improved.Conclusions: We reported improvements in clinical knowledge of CPGs after the EGUIDE program in the 2017 group following revisions of the lecture materials based on the results from the 2016 group. These attempts to improve the degree of understanding of CPGs may facilitate the successful dissemination and implementation of psychiatric guidelines in everyday practice.Trial registration: Effectiveness of Guideline for Dissemination and Education in Psychiatric Treatment, UMIN000022645, Registered 15 June 2016, https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&recptno=R000026044&type=summary&language=J


2020 ◽  
Author(s):  
Shusuke Numata ◽  
Masahito Nakataki ◽  
Naomi Hasegawa ◽  
Yoshikazu Takaesu ◽  
Masahiro Takeshima ◽  
...  

Abstract Background: To implement clinical practice guidelines (CPGs), it is necessary for psychiatrists to deepen their understanding of the CPGs. The Effectiveness of Guidelines for Dissemination and Education in Psychiatric Treatment (EGUIDE) project is a nationwide dissemination and implementation study of two sets of CPGs for schizophrenia and major depressive disorder (MDD).Methods: A total of 413 psychiatrists (n=212 in 2016; n=201 in 2017) learned the two CPGs in the education program of the EGUIDE project over two days, and clinical knowledge of the two CPGs was evaluated by two 37-item questionnaires at baseline and after the EGUIDE programs. To improve the correct answer rate for clinical knowledge after the EGUIDE programs, we revised the lecture materials associated with items that had a low correct answer rate in 2016 and used the revised lecture materials with the CPGs in 2017. The rates of correct answers after the EGUIDE programs for each item between the 2016 and 2017 groups were compared.Results: The total clinical knowledge scores after the EGUIDE program significantly increased in both the 2016 groups and the 2017 groups. We revised lecture materials related to two items in the schizophrenia CPG and five items in the MDD CPG that had low correct answer rates after the EGUIDE programs. The correct answer rate of one item on the schizophrenia CPG and one item on the MDD CPG tended to be improved (S-D5, p=0.038; D-C6, p=0.033) and that of one on the MDD CPG was significantly improved (D-D3, p=0.00080) in the 2017 group compared to those in the 2016 group. The other four items were not significantly improved.Conclusions: We reported improvements in clinical knowledge of CPGs after the EGUIDE program in the 2017 group following revision of the lecture materials based on results from the 2016 group. These attempts to improve the degree of understanding of CPGs may facilitate the successful dissemination and implementation of psychiatric guidelines in everyday practice.Trial registration: Effectiveness of Guideline for Dissemination and Education in Psychiatric Treatment, UMIN000022645, Registered 15 June 2016, https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&recptno=R000026044&type=summary&language=J


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