Assessing remission in major depressive disorder and generalized anxiety disorder clinical trials with the discan metric of the Sheehan disability scale
- 1 March 2011
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in International Clinical Psychopharmacology
- Vol. 26 (2), 75-83
- https://doi.org/10.1097/yic.0b013e328341bb5f
Abstract
Relatively little research has focused on the relationship between functional remission and symptomatic remission in mood and anxiety disorders. This study investigates the relationship and synchrony between symptomatic and functional remission in outpatients with major depressive disorder (MDD) and generalized anxiety disorder (GAD). Using data from three MDD (N = 1419) and four GAD (N = 1847) randomized, placebo-controlled duloxetine studies, we calculated the percentages of patients meeting symptomatic, functional, and combined functional-symptomatic remission criteria for each disorder. We also calculated mean depression [17-item Hamilton depression rating scale (HAMD(17)), Montgomery-Asberg depression rating scale] scores and mean anxiety (Hamilton anxiety rating scale) scores for patients meeting Sheehan disability scale (SDS) functional remission and the mean SDS scores for patients with symptomatic remission. Among the patients with MDD, 38% achieved symptomatic remission (HAMD(17) <= 7), 32% achieved functional remission (SDS <= 6), and 23% achieved combined functional-symptomatic remission. Mean HAMD(17) and Montgomery-Asberg depression rating scale scores for patients with functional remission were approximately 6. Mean SDS total scores for patients with symptomatic remission were 7.1 (patients with HAMD(17) <= 7) and 8.6 (patients with Montgomery-Asberg depression rating scale <= 10). Among the patients with GAD, 30% achieved symptomatic remission (Hamilton anxiety rating scale <= 7), 45% achieved functional remission (SDS <= 6), and 25% achieved combined symptomatic-functional remission. The mean Hamilton anxiety rating scale score in GAD was approximately 8 for patients with functional remission and the mean SDS total score was approximately 4 in patients with symptomatic remission. The study shows that functional remission does not always move in tandem with symptom remission and provides useful anchor points or rules of thumb for evaluating symptomatic and functional remission in MDD and GAD. Int Clin Psychopharmacol 26:75-83 (C) 2011 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.Keywords
This publication has 12 references indexed in Scilit:
- Remission, response without remission, and nonresponse in major depressive disorder: impact on functioningInternational Clinical Psychopharmacology, 2009
- Improvement of psychic and somatic symptoms in adult patients with generalized anxiety disorder: examination from a duloxetine, venlafaxine extended-release and placebo-controlled trialPsychological Medicine, 2008
- Efficacy and safety of duloxetine in the treatment of generalized anxiety disorder: a flexible-dose, progressive-titration, placebo-controlled trialDepression and Anxiety, 2008
- Duloxetine versus escitalopram and placebo: an 8-month, double-blind trial in patients with major depressive disorderCurrent Medical Research and Opinion, 2007
- Duloxetine versus escitalopram and placebo in the treatment of patients with major depressive disorder: onset of antidepressant action, a non-inferiority studyCurrent Medical Research and Opinion, 2007
- Duloxetine in the treatment of major depressive disorder: a placebo- and paroxetine-controlled trialEuropean Psychiatry, 2006
- Report by the ACNP Task Force on Response and Remission in Major Depressive DisorderNeuropsychopharmacology, 2006
- Prevalence, correlates, co-morbidity, and comparative disability of DSM-IV generalized anxiety disorder in the USA: results from the National Epidemiologic Survey on Alcohol and Related ConditionsPsychological Medicine, 2005
- Duloxetine in the acute and long-term treatment of major depressive disorder: a placebo- and paroxetine-controlled trialEuropean Neuropsychopharmacology, 2004
- Generalized anxiety disorder: prevalence, burden, and cost to societyDepression and Anxiety, 2002