Analysis of HAM-D scores and working ability in an observational study of Japanese patients with major depressive disorder and painful physical symptoms treated with duloxetine or SSRI monotherapy.
NEUROPSYCHIATRIC DISEASE AND TREATMENT(2019)
摘要
Objective: To investigate the relationship between Hamilton Depression Rating Scale (HAM-D) score and psychiatrists' judgment of working ability in patients with major depressive disorder (MDD) and painful physical symptoms. Methods: This was a prospective, observational, 12-week study in patients who received duloxetine or a selective serotonin reuptake inhibitor. Patients were >= 20 years old, resided in Japan, and had at least moderate depression (Quick Inventory of Depressive Symptomatology >= 16) and at least moderate painful physical symptoms (Brief Pain Inventory-Short Form average pain >= 3). The main outcome in this post-hoc analysis was the HAM-D17 cutoff best corresponding with patients' working ability according to the investigator's judgment. Area under the receiver-operator curve was used to determine the time point with the strongest relationship between HAM-D17 and working ability. The optimal HAM-D17 cutoff was determined based on the maximum of sensitivity (true positive rate) minus ([1 minus specificity] [true negative rate]). For the evaluation of binary data, a mixed effects model with repeated measures analysis was used. Results: For the estimation of the HAM-D17 cutoff, the area under the receiver-operator curve was maximal at 12 weeks, when a HAM-D17 score of 6 resulted in the best correspondence with working ability in the combined study population. At 12 weeks, a HAM-D17 score of 6 also resulted in the maximum predictive ability in each of the two treatment groups separately. For predicted working ability at 12 weeks, 52.7% of duloxetine-treated patients achieved the HAM-D17 cutoff of <= 6, whereas 48.5% of SSRIs-treated patients achieved HAM-D17 <= 6 (P=0.477). Conclusion: In this study of patients with major depressive disorder and painful physical symptoms, a HAM-D17 score <= 6 corresponded best with patients' working ability. This finding is consistent with previous studies showing that a HAM-D17 cutoff of <= 7 may overestimate functional recovery from MDD.
更多查看译文
关键词
functional recovery,reinstatement,remission
AI 理解论文
溯源树
样例
生成溯源树,研究论文发展脉络
Chat Paper
正在生成论文摘要