residual symptoms and functioning in depression, does the type of residual symptom matter a post-hoc analysis残留症状和功能在抑郁、残留症状问题因果分析的类型.pdfVIP

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residual symptoms and functioning in depression, does the type of residual symptom matter a post-hoc analysis残留症状和功能在抑郁、残留症状问题因果分析的类型.pdf

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residual symptoms and functioning in depression, does the type of residual symptom matter a post-hoc analysis残留症状和功能在抑郁、残留症状问题因果分析的类型

Romera et al. BMC Psychiatry 2013, 13:51 /1471-244X/13/51 RESEARCH ARTICLE Open Access Residual symptoms and functioning in depression, does the type of residual symptom matter? A post-hoc analysis 1,2* 3 1 4 5 1 Irene Romera , Víctor Pérez , Antonio Ciudad , Luis Caballero , Miguel Roca , Pepa Polavieja and Inmaculada Gilaberte1 Abstract Background: The degrees to which residual symptoms in major depressive disorder (MDD) adversely affect patient functioning is not known. This post-hoc analysis explored the association between different residual symptoms and patient functioning. Methods: Patients with MDD who responded (≥50% on the 17-item Hamilton Rating Scale for Depression; HAMD-17) after 3 months of treatment (624/930) were included. Residual core mood-symptoms (HAMD-17 core symptom subscale ≥1), residual insomnia-symptoms (HAMD-17 sleep subscale ≥1), residual anxiety-symptoms (HAMD-17-anxiety subscale ≥1), residual somatic-symptoms (HAMD-17 Item 13 ≥1), pain (Visual Analogue Scale ≥30), and functioning were assessed after 3 months treatment. A stepwise logistic regression model with normal functioning (Social and Occupational Functioning Assessment Scale ≥80) as the dependent variable was used. Results: After 3 months, 59.5% of patients (371/624) achieved normal functioning and 66.0% (412/624) were in remission. Residual symptom prevalence was: core mood symptoms 72%; insomnia 63%; anxiety 78%; and somatic symptoms 41%. Pain reported in 18%. Factors associated with normal functioning were absence of core mood symptoms (odds ratio [OR] 8.7; 95% confidence interval [CI], 4.6– 16.7), absence of insomnia symptoms (OR 1.8; 95% CI, 1.2–2.7), episode length (4–24 weeks vs. ≥24 weeks [OR 2.0; 95% CI, 1.1–3.6])