Residual cognitive and psychosocial functional impairment in outpatients in Greece who responded to conventional antidepressant monotherapy treatments for major depressive disorder (MDD)

Patients with MDD may experience diverse residual symptoms after clinical response to antidepressant treatment. Among these symptoms, cognitive problems in executive functioning are prominent and make functional recovery largely an unmet need for MDD patients. In this study we assessed cognitive sym...

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Veröffentlicht in:Journal of affective disorders 2022-10, Vol.314, p.185-192
Hauptverfasser: Papalexi, E., Galanopoulos, A., Roukas, D., Argyropoulos, I., Michopoulos, I., Douzenis, A., Gkolia, I., Fotiadis, P., Kontis, D., Zervas, I.M.
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container_end_page 192
container_issue
container_start_page 185
container_title Journal of affective disorders
container_volume 314
creator Papalexi, E.
Galanopoulos, A.
Roukas, D.
Argyropoulos, I.
Michopoulos, I.
Douzenis, A.
Gkolia, I.
Fotiadis, P.
Kontis, D.
Zervas, I.M.
description Patients with MDD may experience diverse residual symptoms after clinical response to antidepressant treatment. Among these symptoms, cognitive problems in executive functioning are prominent and make functional recovery largely an unmet need for MDD patients. In this study we assessed cognitive symptoms and functional impairment in patients with MDD responding to antidepressant treatment. This was a national, multi-site, non-interventional, cross-sectional study of depressive symptomatology, cognitive performance and psychosocial functioning in Greek outpatients with MDD who had clinically responded to antidepressant treatment. Both clinician- and patient- rated measures were employed. Symptom remission was assessed with the Montgomery Asberg Depression Rating Scale (MADRS) total score (≤12) and functional recovery was assessed with the Sheehan Disability Scale (SDS) score (
doi_str_mv 10.1016/j.jad.2022.07.009
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Among these symptoms, cognitive problems in executive functioning are prominent and make functional recovery largely an unmet need for MDD patients. In this study we assessed cognitive symptoms and functional impairment in patients with MDD responding to antidepressant treatment. This was a national, multi-site, non-interventional, cross-sectional study of depressive symptomatology, cognitive performance and psychosocial functioning in Greek outpatients with MDD who had clinically responded to antidepressant treatment. Both clinician- and patient- rated measures were employed. Symptom remission was assessed with the Montgomery Asberg Depression Rating Scale (MADRS) total score (≤12) and functional recovery was assessed with the Sheehan Disability Scale (SDS) score (&lt;6). 335 MDD patients participated in the study. After antidepressant monotherapy approximately 60 % of responders and 40 % of remitted patients did not meet the functional recovery criterion. More than 60 % of responders had concentration difficulties as assessed by MADRS item. Patient reported cognitive symptoms were statistically significantly associated with functionality (β coefficient = 0.126, p-value = 0.027). Non-interventional study design and lack of a control group or active comparator/reference. This study highlights the persistence of decreased cognitive performance, particularly in executive functioning in patients with MDD who have shown response and/or remission to antidepressant treatment. This appears to contribute to psychosocial functional impairment. 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More than 60 % of responders had concentration difficulties as assessed by MADRS item. Patient reported cognitive symptoms were statistically significantly associated with functionality (β coefficient = 0.126, p-value = 0.027). Non-interventional study design and lack of a control group or active comparator/reference. This study highlights the persistence of decreased cognitive performance, particularly in executive functioning in patients with MDD who have shown response and/or remission to antidepressant treatment. This appears to contribute to psychosocial functional impairment. Patient-reported cognitive and psychosocial functioning impairment should be included in routine clinical monitoring of outcomes in MDD treatments. •Functional recovery remains an unmet need for MDD patients.•6 out of 10 MDD patients responding to antidepressants remain functionally impaired.•4 out of 10 MDD remitters remain functionally impaired.•Impaired executive functioning impacts MDD patients' functionality.</description><subject>Antidepressants</subject><subject>Executive functioning</subject><subject>Functionality</subject><subject>Major depression</subject><subject>Recovery</subject><issn>0165-0327</issn><issn>1573-2517</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNp9kcFu3CAURVHVSp2m_YDuWKYLOw-wja2uqqRJI6WqFKVrxMBzB2sMLuCp5tf6dWE6WXcD94lzr4BLyEcGNQPWXU31pG3NgfMaZA0wvCIb1kpR8ZbJ12RTmLYCweVb8i6lCQC6QcKG_H3E5Oyq99SEX95ld0CqvaVLOppdSMG4cjSu3mQXfJFuXrSLM_pMnadhzYvOrkzpNN5FRIP0zy7QiGkJ3qKlOZRofyjMOUEXYXEpQCqSzsGHvMOolyPNEXWe_6WNIdJZT2V9YU8Xsy6FaDHSy-83N5_ekzej3if88LJfkJ-3X5-uv1UPP-7ur788VEYIyJVFYHbokW17ywTqppVjMxgJW9502LBth9ZCz7bAOBt6gb1umAGtR9GwQUhxQS7PuUsMv1dMWc0uGdzvtcewJsW7vm-5YJIXlJ1RE0NKEUe1RDfreFQM1KknNanSkzr1pECq0lPxfD57sLzh4DCqZMqPGrQuosnKBvcf9zOv7qDr</recordid><startdate>20221001</startdate><enddate>20221001</enddate><creator>Papalexi, E.</creator><creator>Galanopoulos, A.</creator><creator>Roukas, D.</creator><creator>Argyropoulos, I.</creator><creator>Michopoulos, I.</creator><creator>Douzenis, A.</creator><creator>Gkolia, I.</creator><creator>Fotiadis, P.</creator><creator>Kontis, D.</creator><creator>Zervas, I.M.</creator><general>Elsevier B.V</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20221001</creationdate><title>Residual cognitive and psychosocial functional impairment in outpatients in Greece who responded to conventional antidepressant monotherapy treatments for major depressive disorder (MDD)</title><author>Papalexi, E. ; Galanopoulos, A. ; Roukas, D. ; Argyropoulos, I. ; Michopoulos, I. ; Douzenis, A. ; Gkolia, I. ; Fotiadis, P. ; Kontis, D. ; Zervas, I.M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c330t-de01d98e1b8d13ea457f49c70b246e41b6edd081b0121983e8a41c0aaf3419373</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Antidepressants</topic><topic>Executive functioning</topic><topic>Functionality</topic><topic>Major depression</topic><topic>Recovery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Papalexi, E.</creatorcontrib><creatorcontrib>Galanopoulos, A.</creatorcontrib><creatorcontrib>Roukas, D.</creatorcontrib><creatorcontrib>Argyropoulos, I.</creatorcontrib><creatorcontrib>Michopoulos, I.</creatorcontrib><creatorcontrib>Douzenis, A.</creatorcontrib><creatorcontrib>Gkolia, I.</creatorcontrib><creatorcontrib>Fotiadis, P.</creatorcontrib><creatorcontrib>Kontis, D.</creatorcontrib><creatorcontrib>Zervas, I.M.</creatorcontrib><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of affective disorders</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Papalexi, E.</au><au>Galanopoulos, A.</au><au>Roukas, D.</au><au>Argyropoulos, I.</au><au>Michopoulos, I.</au><au>Douzenis, A.</au><au>Gkolia, I.</au><au>Fotiadis, P.</au><au>Kontis, D.</au><au>Zervas, I.M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Residual cognitive and psychosocial functional impairment in outpatients in Greece who responded to conventional antidepressant monotherapy treatments for major depressive disorder (MDD)</atitle><jtitle>Journal of affective disorders</jtitle><date>2022-10-01</date><risdate>2022</risdate><volume>314</volume><spage>185</spage><epage>192</epage><pages>185-192</pages><issn>0165-0327</issn><eissn>1573-2517</eissn><abstract>Patients with MDD may experience diverse residual symptoms after clinical response to antidepressant treatment. Among these symptoms, cognitive problems in executive functioning are prominent and make functional recovery largely an unmet need for MDD patients. In this study we assessed cognitive symptoms and functional impairment in patients with MDD responding to antidepressant treatment. This was a national, multi-site, non-interventional, cross-sectional study of depressive symptomatology, cognitive performance and psychosocial functioning in Greek outpatients with MDD who had clinically responded to antidepressant treatment. Both clinician- and patient- rated measures were employed. Symptom remission was assessed with the Montgomery Asberg Depression Rating Scale (MADRS) total score (≤12) and functional recovery was assessed with the Sheehan Disability Scale (SDS) score (&lt;6). 335 MDD patients participated in the study. After antidepressant monotherapy approximately 60 % of responders and 40 % of remitted patients did not meet the functional recovery criterion. More than 60 % of responders had concentration difficulties as assessed by MADRS item. Patient reported cognitive symptoms were statistically significantly associated with functionality (β coefficient = 0.126, p-value = 0.027). Non-interventional study design and lack of a control group or active comparator/reference. This study highlights the persistence of decreased cognitive performance, particularly in executive functioning in patients with MDD who have shown response and/or remission to antidepressant treatment. This appears to contribute to psychosocial functional impairment. Patient-reported cognitive and psychosocial functioning impairment should be included in routine clinical monitoring of outcomes in MDD treatments. •Functional recovery remains an unmet need for MDD patients.•6 out of 10 MDD patients responding to antidepressants remain functionally impaired.•4 out of 10 MDD remitters remain functionally impaired.•Impaired executive functioning impacts MDD patients' functionality.</abstract><pub>Elsevier B.V</pub><doi>10.1016/j.jad.2022.07.009</doi><tpages>8</tpages></addata></record>
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subjects Antidepressants
Executive functioning
Functionality
Major depression
Recovery
title Residual cognitive and psychosocial functional impairment in outpatients in Greece who responded to conventional antidepressant monotherapy treatments for major depressive disorder (MDD)
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