title: Residual symptoms and functionality in depressed outpatients: A one-year observational study in Switzerland with escitalopram.
abstract: BACKGROUND
  Residual depressive symptoms are associated with a poor prognosis for relapse or recurrence and are recognized as impeding factors of functionality. Recovery to the pre-depression level of functioning should be the goal of treatment.
  
  
  OBJECTIVE
  To evaluate outcomes in depressed outpatients treated with escitalopram regarding response, recovery, residual symptoms, functionality and ability to work over 48 weeks.
  
  
  METHODS
  3278 outpatients were evaluated at weeks 8, 24 and 48. A simple questionnaire was used to rate severity of illness, impairment of functionality, treatment response, tolerability, presence and severity of residual symptoms, whether remission with residual symptoms or recovery was achieved, and to what degree the patient was able to work.
  
  
  RESULTS
  Data over the full 48-week period were available for 75.8% of patients, for whom treatment response was rated as "very good" or "good" in 81%. However, only 42% of the completing patients achieved recovery without residual symptoms, while 41% were rated as remitters with residual symptoms. Lack of energy/motivation was the most common reported residual symptom and was present in 23.5% of patients at study end. Concentration difficulties were present in 15.8% and impaired sleep in 13.9% of patients. Complete inability to work decreased from 36% at baseline to 9% at week 48, while full-time working capacity increased from 37% to 62%.
  
  
  CONCLUSIONS
  Non-controlled observational real life study using simple ratings rather than established rating scales.
  
  
  CONCLUSIONS
  <50% of patients completing a one-year antidepressant treatment regimen were rated as being symptomatically fully recovered, and ≈50% still reported functional deficits.
authors.affiliation: Lundbeck (Switzerland) Ltd, Cherstrasse 4, CH 8152 Glattbrugg, Switzerland. Electronic address: rcn@depressionen.ch.
authors.forename: Rico
authors.initials: R
authors.lastname: Nil
authors.affiliation: Lundbeck (Switzerland) Ltd, Cherstrasse 4, CH 8152 Glattbrugg, Switzerland.
authors.forename: Simone
authors.initials: S
authors.lastname: Lütolf
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, Hospital of Psychiatry University of Zurich, Zurich, Switzerland.
authors.forename: Erich
authors.initials: E
authors.lastname: Seifritz
mesh_terms: D000328:Adult; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D015283:Citalopram / Q000627:therapeutic use*; D003863:Depression / Q000175:diagnosis* / Q000523:psychology*; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053609:Lethargy; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D012008:Recurrence; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013557:Switzerland; D016896:Treatment Outcome
chemical_list: D018687:Antidepressive Agents, Second-Generation; D015283:Citalopram; D017367:Selective Serotonin Reuptake Inhibitors
keywords: Depression; Long-term treatment; Recovery; Residual symptoms; Work functioning