title: Predictors of remission in the treatment of major depressive disorder: real-world evidence from a 6-month prospective observational study.
abstract: BACKGROUND
  This study examined potential predictors of remission among patients treated for major depressive disorder (MDD) in a naturalistic clinical setting, mostly in the Middle East, East Asia, and Mexico.
  
  
  METHODS
  Data for this post hoc analysis were taken from a 6-month prospective, noninterventional, observational study that involved 1,549 MDD patients without sexual dysfunction at baseline in 12 countries worldwide. Depression severity was measured using the Clinical Global Impression of Severity and the 16-item Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR16). Depression-related pain was measured using the pain-related items of the Somatic Symptom Inventory. Remission was defined as a QIDS-SR16 score ≤5. Generalized estimating equation regression models were used to examine baseline factors associated with remission during follow-up.
  
  
  RESULTS
  Being from East Asia (odds ratio [OR] 0.48 versus Mexico; P<0.001), a higher level of depression severity at baseline (OR 0.77, P=0.003, for Clinical Global Impression of Severity; OR 0.92, P<0.001, for QIDS-SR16), more previous MDD episodes (OR 0.92, P=0.007), previous treatments/therapies for depression (OR 0.78, P=0.030), and having any significant psychiatric and medical comorbidity at baseline (OR 0.60, P<0.001) were negatively associated with remission, whereas being male (OR 1.29, P=0.026) and treatment with duloxetine (OR 2.38 versus selective serotonin reuptake inhibitors, P<0.001) were positively associated with remission. However, the association between Somatic Symptom Inventory pain scores and remission no longer appeared to be significant in this multiple regression (P=0.580), (P=0.008 in descriptive statistics), although it remained significant in a subgroup of patients treated with selective serotonin reuptake inhibitors (OR 0.97, P=0.023), but not in those treated with duloxetine (P=0.182).
  
  
  CONCLUSIONS
  These findings are largely consistent with previous reports from the USA and Europe. They also highlight the potential mediating role of treatment with duloxetine on the negative relationship between depression-related pain and outcomes of depression.
authors: Eli Lilly and Company, Windlesham, UK.
authors: Diego
authors: D
authors: Novick
authors: Eli Lilly and Company, Windlesham, UK.
authors: Jihyung
authors: J
authors: Hong
authors: Eli Lilly Australia Pty Ltd, West Ryde, Australia.
authors: William
authors: W
authors: Montgomery
authors: Eli Lilly de Mexico, Mexico City, Mexico.
authors: Héctor
authors: H
authors: Dueñas
authors: Eli Lilly and Company, Riyadh, Saudi Arabia.
authors: Magdy
authors: M
authors: Gado
authors: Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain.
authors: Josep Maria
authors: JM
authors: Haro
keywords: Asia; Mexico; Middle East; antidepressant; duloxetine; selective serotonin reuptake inhibitors
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