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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

Distribution of Sheehan Disability Scale scores over the course of the study.Notes: Grey represents inclusion visit; white represents 6-week follow-up visit; black represents 12-week follow-up visit.
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f2-ndt-8-605: Distribution of Sheehan Disability Scale scores over the course of the study.Notes: Grey represents inclusion visit; white represents 6-week follow-up visit; black represents 12-week follow-up visit.

Mentions: At inclusion, 77.1% of patients (n = 6449) scored ≥7 (marked or extreme disability) on at least one dimension of the SDS and 29.4% (n = 2467) scored ≥7 on all three dimensions. At the 12-week follow-up, the proportion of patients scoring ≥ 7 on any dimension had decreased to 9.2% (n = 604) and the proportion scoring ≥ 7 on all dimensions to 2.7% (n = 178). The proportion of patients scoring < 4 (no or mild disability) on all three SDS dimensions rose over the course of the study from 2.4% (n = 202) to 64.6% (n = 4261). Functional remission rates defined as an SDS subscore of 0 were 18.0% for the work/school dimension, 16.8% for the social activities dimension, and 19.5% for the family life dimensions. Using a subscore of ≤2 as the threshold, remission rates were 56.8%, 55.0%, and 58.0%, respectively. The distribution of SDS dimension scores over the course of the study is presented in Figure 2.


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)

Distribution of Sheehan Disability Scale scores over the course of the study.Notes: Grey represents inclusion visit; white represents 6-week follow-up visit; black represents 12-week follow-up visit.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3526151&req=5

f2-ndt-8-605: Distribution of Sheehan Disability Scale scores over the course of the study.Notes: Grey represents inclusion visit; white represents 6-week follow-up visit; black represents 12-week follow-up visit.
Mentions: At inclusion, 77.1% of patients (n = 6449) scored ≥7 (marked or extreme disability) on at least one dimension of the SDS and 29.4% (n = 2467) scored ≥7 on all three dimensions. At the 12-week follow-up, the proportion of patients scoring ≥ 7 on any dimension had decreased to 9.2% (n = 604) and the proportion scoring ≥ 7 on all dimensions to 2.7% (n = 178). The proportion of patients scoring < 4 (no or mild disability) on all three SDS dimensions rose over the course of the study from 2.4% (n = 202) to 64.6% (n = 4261). Functional remission rates defined as an SDS subscore of 0 were 18.0% for the work/school dimension, 16.8% for the social activities dimension, and 19.5% for the family life dimensions. Using a subscore of ≤2 as the threshold, remission rates were 56.8%, 55.0%, and 58.0%, respectively. The distribution of SDS dimension scores over the course of the study is presented in Figure 2.

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