title: Patient-reported outcomes before and after treatment of major depressive disorder.
abstract: Patient reported outcomes (PROs) of quality of life (QoL), functioning, and depressive symptom severity are important in assessing the burden of illness of major depressive disorder (MDD) and to evaluate the impact of treatment. We sought to provide a detailed analysis of PROs before and after treatment of MDD from the large Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study. This analysis examines PROs before and after treatment in the second level of STAR*D. The complete data on QoL, functioning, and depressive symptom severity, were analyzed for each STAR*D level 2 treatment. PROs of QoL, functioning, and depressive symptom severity showed substantial impairments after failing a selective serotonin reuptake inhibitor trial using citalopram (level 1). The seven therapeutic options in level 2 had positive statistically (P values) and clinically (Cohen's standardized differences [Cohen's d]) significant impact on QoL, functioning, depressive symptom severity, and reduction in calculated burden of illness. There were no statistically significant differences between the interventions. However, a substantial proportion of patients still suffered from patient-reported QoL and functioning impairment after treatment, an effect that was more pronounced in nonremitters. PROs are crucial in understanding the impact of MDD and in examining the effects of treatment interventions, both in research and clinical settings.
authors.affiliation: Vice Chairman for Education & Research and Consultant Psychiatrist, Cedars-Sinai Department of Psychiatry and Behavioral Neurosciences, Los Angeles, California, USA; Cedars-Sinai Department of Psychiatry and Behavioral Neurosciences, Los Angeles, California, USA; David Geffen School of Medicine at University of California Los Angeles (UCLA), Los Angeles, California, USA.
authors.forename: Waguih William
authors.initials: WW
authors.lastname: IsHak
authors.affiliation: Cedars-Sinai Department of Psychiatry and Behavioral Neurosciences, Los Angeles, California, USA.
authors.forename: James
authors.initials: J
authors.lastname: Mirocha
authors.affiliation: Cedars-Sinai Department of Psychiatry and Behavioral Neurosciences, Los Angeles, California, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Pi
authors.affiliation: Cedars-Sinai Department of Psychiatry and Behavioral Neurosciences, Los Angeles, California, USA.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Tobia
authors.affiliation: Cedars-Sinai Department of Psychiatry and Behavioral Neurosciences, Los Angeles, California, USA.
authors.forename: Bret
authors.initials: B
authors.lastname: Becker
authors.affiliation: Richmond University Medical Center and Freedom From Fear, Staten Island, New York, USA.
authors.forename: Eric D
authors.initials: ED
authors.lastname: Peselow
authors.affiliation: Department of Psychiatry, Emory University School of Medicine.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Cohen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016208:Databases, Factual / Q000706:statistics & numerical data; D003865:Major Depressive Disorder / Q000523:psychology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012189:Retrospective Studies; D057566:Self Report; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014481:United States; D055815:Young Adult
keywords: STAR*D; functioning; individual burden of illness; major depressive disorder; quality of life