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Disability in patients consulting for anxiety or mood disorders in primary care: response to antidepressant treatment.

Gérard A, Liard F, Crochard A, Goni S, Millet B - Neuropsychiatr Dis Treat (2012)

Bottom Line: At the 12-week follow-up visit, 90.0% of patients were responders (defined as patients whose SDS dimension scores decreased by at least one point) on the work/school SDS subscores; 92.8% were responders on the social life SDS subscores, and 91.1% were responders on family life/home responsibilities SDS subscores.Improvements in self-rated disability were correlated with improvements in symptoms measured with clinician-rated CGI-S.Patients consulting for anxiety or mood disorders report significant disability, which can be effectively reduced by antidepressant treatment.

View Article: PubMed Central - PubMed

Affiliation: Rue des Marronniers' Psychiatry Clinic, Paris.

ABSTRACT

Background: The primary objective of this prospective observational study was to evaluate changes in self-reported disability in patients with anxiety or mood disorders 3 months after initiating antidepressant treatment.

Methods: This study included 8396 patients consulting 2433 general practitioners in France for a major mood episode, generalized anxiety disorder, social anxiety disorder, panic disorder, or obsessive-compulsive disorder. Treatment was initiated with the antidepressant that the physician considered appropriate. Patients were evaluated with the Sheehan Disability Scale (SDS), Hospital Anxiety and Depression Scale, and Clinical Global Impression-Severity (CGI-S) at baseline and after 6 and 12 weeks.

Results: At 12 weeks, 6617 patients (78.8%) were evaluable. At inclusion, the mean SDS subscores were 6.5 ± 2.2 on the work/school activities dimension, 6.8 ± 1.9 on the social activities dimension, and 6.5 ± 2.0 on the family life dimension. At the 12-week follow-up visit, the mean change in score on these three dimensions was -3.9 ± 2.6, -4.2 ± 2.5, and -4.0 ± 2.5, respectively. At the 12-week follow-up visit, 90.0% of patients were responders (defined as patients whose SDS dimension scores decreased by at least one point) on the work/school SDS subscores; 92.8% were responders on the social life SDS subscores, and 91.1% were responders on family life/home responsibilities SDS subscores. Functional remission (defined as an SDS subscore of 0 at study end) rates were 18.0% for the work/school dimension, 16.8% for the social activities dimension, and 19.5% for the family life dimension. Using a cutoff of ≤2, remission rates were 56.8%, 55.0%, and 58.0%, respectively. Improvements in self-rated disability were correlated with improvements in symptoms measured with clinician-rated CGI-S.

Conclusion: Patients consulting for anxiety or mood disorders report significant disability, which can be effectively reduced by antidepressant treatment.

No MeSH data available.


Related in: MedlinePlus

Patient flow through the study.Note: The tolerance windows for the 6-week and 12-week follow-up visits were 2 and 3 weeks, respectively.Abbreviations: MDE, major depressive episode; GAD, generalized anxiety disorder; SAD, social anxiety disorder; PD, panic disorder; OCD, obsessive-compulsive disorder.
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f1-ndt-8-605: Patient flow through the study.Note: The tolerance windows for the 6-week and 12-week follow-up visits were 2 and 3 weeks, respectively.Abbreviations: MDE, major depressive episode; GAD, generalized anxiety disorder; SAD, social anxiety disorder; PD, panic disorder; OCD, obsessive-compulsive disorder.

Mentions: Overall, 2433 general practitioners participated in the study and included 8396 patients. Of these patients, 6977 (83.1%) attended a follow-up visit within the prespecified tolerance window at 6 weeks, and 6617 (78.8%) at 12 weeks (Figure 1). There was no marked difference in the rate of retention at 12 weeks between patients with different diagnoses, ranging from 75.8% for patients with social anxiety disorder to 79.9% in patients with obsessive-compulsive disorder. The most frequent diagnosis was major depressive episode (n = 6270, 74.7%) and the least frequent obsessive-compulsive disorder (n = 373, 4.4%, Table 1). However, multiple diagnoses were reported for many patients (n = 2280, 27.2%); most frequently major depressive episode was comorbid with an anxiety disorder (n = 1871, 82.1% of patients with comorbid disorders), and, for all diagnoses except major depressive episode, comorbid diagnoses were more frequent than isolated disorders.


Disability in patients consulting for anxiety or mood disorders in primary care: response to antidepressant treatment.

Gérard A, Liard F, Crochard A, Goni S, Millet B - Neuropsychiatr Dis Treat (2012)

Patient flow through the study.Note: The tolerance windows for the 6-week and 12-week follow-up visits were 2 and 3 weeks, respectively.Abbreviations: MDE, major depressive episode; GAD, generalized anxiety disorder; SAD, social anxiety disorder; PD, panic disorder; OCD, obsessive-compulsive disorder.
© Copyright Policy
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC3526151&req=5

f1-ndt-8-605: Patient flow through the study.Note: The tolerance windows for the 6-week and 12-week follow-up visits were 2 and 3 weeks, respectively.Abbreviations: MDE, major depressive episode; GAD, generalized anxiety disorder; SAD, social anxiety disorder; PD, panic disorder; OCD, obsessive-compulsive disorder.
Mentions: Overall, 2433 general practitioners participated in the study and included 8396 patients. Of these patients, 6977 (83.1%) attended a follow-up visit within the prespecified tolerance window at 6 weeks, and 6617 (78.8%) at 12 weeks (Figure 1). There was no marked difference in the rate of retention at 12 weeks between patients with different diagnoses, ranging from 75.8% for patients with social anxiety disorder to 79.9% in patients with obsessive-compulsive disorder. The most frequent diagnosis was major depressive episode (n = 6270, 74.7%) and the least frequent obsessive-compulsive disorder (n = 373, 4.4%, Table 1). However, multiple diagnoses were reported for many patients (n = 2280, 27.2%); most frequently major depressive episode was comorbid with an anxiety disorder (n = 1871, 82.1% of patients with comorbid disorders), and, for all diagnoses except major depressive episode, comorbid diagnoses were more frequent than isolated disorders.

Bottom Line: At the 12-week follow-up visit, 90.0% of patients were responders (defined as patients whose SDS dimension scores decreased by at least one point) on the work/school SDS subscores; 92.8% were responders on the social life SDS subscores, and 91.1% were responders on family life/home responsibilities SDS subscores.Improvements in self-rated disability were correlated with improvements in symptoms measured with clinician-rated CGI-S.Patients consulting for anxiety or mood disorders report significant disability, which can be effectively reduced by antidepressant treatment.

View Article: PubMed Central - PubMed

Affiliation: Rue des Marronniers' Psychiatry Clinic, Paris.

ABSTRACT

Background: The primary objective of this prospective observational study was to evaluate changes in self-reported disability in patients with anxiety or mood disorders 3 months after initiating antidepressant treatment.

Methods: This study included 8396 patients consulting 2433 general practitioners in France for a major mood episode, generalized anxiety disorder, social anxiety disorder, panic disorder, or obsessive-compulsive disorder. Treatment was initiated with the antidepressant that the physician considered appropriate. Patients were evaluated with the Sheehan Disability Scale (SDS), Hospital Anxiety and Depression Scale, and Clinical Global Impression-Severity (CGI-S) at baseline and after 6 and 12 weeks.

Results: At 12 weeks, 6617 patients (78.8%) were evaluable. At inclusion, the mean SDS subscores were 6.5 ± 2.2 on the work/school activities dimension, 6.8 ± 1.9 on the social activities dimension, and 6.5 ± 2.0 on the family life dimension. At the 12-week follow-up visit, the mean change in score on these three dimensions was -3.9 ± 2.6, -4.2 ± 2.5, and -4.0 ± 2.5, respectively. At the 12-week follow-up visit, 90.0% of patients were responders (defined as patients whose SDS dimension scores decreased by at least one point) on the work/school SDS subscores; 92.8% were responders on the social life SDS subscores, and 91.1% were responders on family life/home responsibilities SDS subscores. Functional remission (defined as an SDS subscore of 0 at study end) rates were 18.0% for the work/school dimension, 16.8% for the social activities dimension, and 19.5% for the family life dimension. Using a cutoff of ≤2, remission rates were 56.8%, 55.0%, and 58.0%, respectively. Improvements in self-rated disability were correlated with improvements in symptoms measured with clinician-rated CGI-S.

Conclusion: Patients consulting for anxiety or mood disorders report significant disability, which can be effectively reduced by antidepressant treatment.

No MeSH data available.


Related in: MedlinePlus