A descriptive analysis of quality of life using patient-reported measures in major depressive disorder in a naturalistic outpatient setting

IsHak, Waguih William; Balayan, Konstantin; Bresee, Catherine; Greenberg, Jared M.; Fakhry, Hala; Christensen, Scott; Rapaport, Mark Hyman

doi:10.1007/s11136-012-0187-6

Cited by 76 publications

(66 citation statements)

References 28 publications

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“…This process is repeated in subsequent visits, monthly, quarterly, or guided by the clinical presentation. As explained in previously published work, an IBI-D index of 0 indicates an average burden of illness for an individual seeking treatment for depression, an IBI-D index of −2 indicates a remarkably low burden of illness that is less than 98% of depressed patients seeking treatment, and an index of 2 indicates a remarkably high burden of illness that is exceeded by only 2% of depressed patients (IsHak et al, 2013). We know that patients with high burden of illness have a lower probability of response to standard SSRI antidepressant treatment.…”

Section: Clinical Applicationmentioning

confidence: 89%

“…The limitations of the IBI-D were highlighted before (IsHak et al, 2013; Rush et al, 2004). Briefly, the IBI-D requires time and effort for a patient to fill out the underlying scales (20–30 min), in addition to the measures and index calculation (5–10 min of clinician time).…”

Section: Limitationsmentioning

confidence: 99%

“…The Individual Burden of Illness Index for Depression (IBI-D) was developed and validated as a means of providing a single measure that would accurately reflect the degree to which an individual patient is suffering from depression (IsHak et al, 2013). Following on the above conceptualization, the IBI-D was the name given to the first and only statistically significant principal component obtained from a principal component analysis (PCA) of well-validated patient-reported outcomes of depressive symptom severity, functioning, and QOL: the Quick Inventory of Depressive Symptomatology-Self Report (QIDS-SR) (Rush et al, 2003), the Work and Social Adjustment Scale (WSAS) (Mundt et al, 2002), and the Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q) (Endicott et al, 1993), respectively.…”

Section: Introductionmentioning

confidence: 99%

“…Following on the above conceptualization, the IBI-D was the name given to the first and only statistically significant principal component obtained from a principal component analysis (PCA) of well-validated patient-reported outcomes of depressive symptom severity, functioning, and QOL: the Quick Inventory of Depressive Symptomatology-Self Report (QIDS-SR) (Rush et al, 2003), the Work and Social Adjustment Scale (WSAS) (Mundt et al, 2002), and the Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q) (Endicott et al, 1993), respectively. The initial exploratory PCA was based on the patient-reported measures from MDD patients in the Cedars-Sinai Psychiatric Treatment Outcome Registry (IsHak et al, 2013) and the confirmatory analysis was based on the patient-reported measures of patients enrolled in Level 1 of the NIMH Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial study at their time of entry (Rush et al, 2004; Fava et al, 2003). More recently the single IBI-D number was shown to provide an accurate accounting of the multidimensional impact of antidepressant treatment (Cohen et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

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Predicting relapse in major depressive disorder using patient-reported outcomes of depressive symptom severity, functioning, and quality of life in the individual burden of illness index for depression (IBI-D)

IsHak

Greenberg

Cohen

2013

Journal of Affective Disorders

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Background Patients with Major Depressive Disorder (MDD) often experience unexpected relapses, despite achieving remission. This study examines the utility of a single multidimensional measure that captures variance in patient-reported Depressive Symptom Severity, Functioning, and Quality of Life (QOL), in predicting MDD relapse. Methods Complete data from remitted patients at the completion of 12 weeks of citalopram in the STAR*D study were used to calculate the Individual Burden of Illness index for Depression (IBI-D), and predict subsequent relapse at six (n = 956), nine (n = 778), and twelve months (n = 479) using generalized linear models. Results Depressive Symptom Severity, Functioning, and QOL were all predictors of subsequent relapse. Using Akaike information criteria (AIC), the IBI-D provided a good model for relapse even when Depressive Symptom Severity, Functioning, and QOL were combined in a single model. Specifically, an increase of one in the IBI-D increased the odds ratio of relapse by 2.5 at 6 months (β = 0.921 ± 0.194, z = 4.76, p < 2 × 10−6), by 2.84 at 9 months (β = 1.045 ± 0.22, z = 4.74, p < 2.2 × 10−6), and by 4.1 at 12 months (β = 1.41 ± 0.29, z = 4.79, p < 1.7 × 10−6). Limitations Self-report poses a risk to measurement precision. Using highly valid and reliable measures could mitigate this risk. The IBI-D requires time and effort for filling out the scales and index calculation. Technological solutions could help ease these burdens. The sample suffered from attrition. Separate analysis of dropouts would be helpful. Conclusions Incorporating patient-reported outcomes of Functioning and QOL in addition to Depressive Symptom Severity in the IBI-D is useful in assessing the full burden of illness and in adequately predicting relapse, in MDD.

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Section: Clinical Applicationmentioning

confidence: 89%

Section: Limitationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Predicting relapse in major depressive disorder using patient-reported outcomes of depressive symptom severity, functioning, and quality of life in the individual burden of illness index for depression (IBI-D)

IsHak

Greenberg

Cohen

2013

Journal of Affective Disorders

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“…Additionally, studies have focused on prediction of eventual symptom-based definitions of clinical response or remission. Because there is increasing recognition that functional improvement and quality of life are more important than symptom improvement as a treatment outcome for patients with MDD [31,32], future research should also examine early symptom improvement as a predictor of functional and quality-of-life outcomes.…”

Section: Future Research Directionsmentioning

confidence: 99%

Early Switching Strategies in Antidepressant Non-Responders: Current Evidence and Future Research Directions

2014

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Studies have found that up to two-thirds of patients with major depressive disorder (MDD) do not fully respond to the first antidepressant. While switching antidepressants is a common strategy for antidepressant nonresponders, there is still a lack of consensus about the optimal timing of a switch. Many clinicians wait for 6-12 weeks before considering a switch. The objectives of this paper are to (1) review the evidence for positive and negative predictive value (NPV) of early improvement at 2-4 weeks to predict final antidepressant response; (2) review randomized controlled trials (RCTs) that examine early switching strategies; and (3) provide future research directions and clinical recommendations for timing of antidepressant switching. We conducted a literature search for English

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Venlafaxine Extended-Release for Depression Following Spinal Cord Injury

et al. 2015

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IMPORTANCE Depression is prevalent and associated with negative outcomes in individuals with spinal cord injury (SCI). Antidepressants are used routinely to treat depression, yet no placebo-controlled trials have been published in this population to our knowledge. OBJECTIVE To determine the efficacy and tolerability of venlafaxine hydrochloride extended-release (XR) for major depressive disorder (MDD) or dysthymic disorder in persons with chronic SCI. DESIGN, SETTING, AND PARTICIPANTS Multisite, randomized (1:1), double-blind, placebo-controlled Project to Improve Symptoms and Mood After SCI (PRISMS) trial. All research staff conducting screening, intervention, and outcome procedures were blinded to randomization status. We screened 2536 patients from outpatient clinics at 6 SCI treatment centers in the United States and randomized 133 participants into the trial. Participants were 18 to 64 years old and at least 1 month after SCI, with MDD or dysthymic disorder. Seventy-four percent of participants were male, and participants were on average 40 years old and 11 years after SCI. Forty-seven percent had cervical injuries, 53.4% had American Spinal Injury Association injury severity A (complete injury) SCI, 24.1% had at least 2 prior MDD episodes, and 99.2% had current MDD. Common comorbidities included chronic pain (93.9%), significant anxiety (57.1%), and history of substance dependence (44.4%). INTERVENTIONS Twelve-week trial of venlafaxine XR vs placebo using a flexible-dose algorithm. MAIN OUTCOMES AND MEASURES The Hamilton Depression Rating Scale (HAM-D 17-item version and Maier subscale, which focuses on core depression symptoms and excludes somatic symptoms) over 12 weeks. RESULTS Mixed-effects models revealed a significant difference between the venlafaxine XR and placebo groups in improvement on the Maier subscale from baseline to 12 weeks (treatment effect, 1.6; 95% CI, 0.3-2.9; P = .02) but not on the HAM-D 17-item version (treatment effect, 1.0; 95% CI, −1.4 to 3.4; P = .42). Participants receiving venlafaxine XR reported significantly less SCI-related disability on the Sheehan Disability Scale at 12 weeks compared with placebo (treatment effect, 4.7; 95% CI, 1.5-7.8; P = .005). Blurred vision was the only significantly more common new or worsening adverse effect in the venlafaxine XR group compared with the placebo group over 12 weeks. CONCLUSIONS AND RELEVANCE Venlafaxine XR was well tolerated by most patients and an effective antidepressant for decreasing core symptoms of depression and improving SCI-related disability. Further research is needed to determine the optimal treatment and measurement approaches for depression in chronic SCI. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00592384

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A descriptive analysis of quality of life using patient-reported measures in major depressive disorder in a naturalistic outpatient setting

Cited by 76 publications

References 28 publications

Predicting relapse in major depressive disorder using patient-reported outcomes of depressive symptom severity, functioning, and quality of life in the individual burden of illness index for depression (IBI-D)

Predicting relapse in major depressive disorder using patient-reported outcomes of depressive symptom severity, functioning, and quality of life in the individual burden of illness index for depression (IBI-D)

Early Switching Strategies in Antidepressant Non-Responders: Current Evidence and Future Research Directions

Venlafaxine Extended-Release for Depression Following Spinal Cord Injury

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