Clustering and drivers of symptoms observed at week six after antidepressant treatment in depressed outpatients
Abstract Background Depressive symptoms remaining after antidepressant treatment increase the risk of relapse and recurrence. We aimed to analyze the distribution and main drivers of remaining symptoms in patients with a major depressive episode. Methods Two independent samples of 8,229 and 5,92...
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| Language: | English |
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Cambridge University Press
2024-01-01
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| Series: | European Psychiatry |
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| Online Access: | https://www.cambridge.org/core/product/identifier/S0924933824018017/type/journal_article |
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| author | Michel Danon Daphnée Poupon Philippe Courtet Philip Gorwood |
| author_facet | Michel Danon Daphnée Poupon Philippe Courtet Philip Gorwood |
| author_sort | Michel Danon |
| collection | DOAJ |
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Abstract
Background
Depressive symptoms remaining after antidepressant treatment increase the risk of relapse and recurrence. We aimed to analyze the distribution and main drivers of remaining symptoms in patients with a major depressive episode.
Methods
Two independent samples of 8,229 and 5,926 patients from two large naturalistic studies were retrospectively analyzed. DSM-IV criteria for major depressive episodes were assessed during two face-to-face visits with clinicians: before the prescription of a new antidepressant, and after 6 weeks of treatment. The Hospital Anxiety and Depression Scale (HADS) was used to assess baseline severity of anxiety and depression.
Results
In both samples, two clusters of remaining symptoms were observed. The first cluster encompassed symptoms related to a negative emotional and cognitive bias and was specifically driven by the baseline severity of depression. The second cluster encompassed neurovegetative symptoms and was specifically driven by the baseline severity of anxiety.
Conclusions
The baseline anxiety-depressive balance of patients could be considered to adapt the treatment, focusing on emotional and cognitive symptoms with patients with high baseline severity of depression, and neurovegetative symptoms with patients with high baseline anxiety severity.
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| format | Article |
| id | doaj-art-33ead4fddc7048a7a031ef9905b4f3b4 |
| institution | Kabale University |
| issn | 0924-9338 1778-3585 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | European Psychiatry |
| spelling | doaj-art-33ead4fddc7048a7a031ef9905b4f3b42025-01-17T09:38:03ZengCambridge University PressEuropean Psychiatry0924-93381778-35852024-01-016710.1192/j.eurpsy.2024.1801Clustering and drivers of symptoms observed at week six after antidepressant treatment in depressed outpatientsMichel Danon0https://orcid.org/0000-0002-5716-2065Daphnée Poupon1https://orcid.org/0000-0002-3712-0511Philippe Courtet2https://orcid.org/0000-0002-6519-8586Philip Gorwood3https://orcid.org/0000-0003-1845-3676Clinique des Maladies Mentales et de l’Encéphale, GHU Paris Psychiatrie et Neurosciences, Paris, France Université Paris Cité, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Paris, FranceClinique des Maladies Mentales et de l’Encéphale, GHU Paris Psychiatrie et Neurosciences, Paris, FranceDepartment of Emergency Psychiatry and Post-Acute Care, CHU Montpellier, France IGF, Hôpital La Colombière, University of Montpellier, Montpellier, FranceClinique des Maladies Mentales et de l’Encéphale, GHU Paris Psychiatrie et Neurosciences, Paris, France Université Paris Cité, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Paris, France Abstract Background Depressive symptoms remaining after antidepressant treatment increase the risk of relapse and recurrence. We aimed to analyze the distribution and main drivers of remaining symptoms in patients with a major depressive episode. Methods Two independent samples of 8,229 and 5,926 patients from two large naturalistic studies were retrospectively analyzed. DSM-IV criteria for major depressive episodes were assessed during two face-to-face visits with clinicians: before the prescription of a new antidepressant, and after 6 weeks of treatment. The Hospital Anxiety and Depression Scale (HADS) was used to assess baseline severity of anxiety and depression. Results In both samples, two clusters of remaining symptoms were observed. The first cluster encompassed symptoms related to a negative emotional and cognitive bias and was specifically driven by the baseline severity of depression. The second cluster encompassed neurovegetative symptoms and was specifically driven by the baseline severity of anxiety. Conclusions The baseline anxiety-depressive balance of patients could be considered to adapt the treatment, focusing on emotional and cognitive symptoms with patients with high baseline severity of depression, and neurovegetative symptoms with patients with high baseline anxiety severity. https://www.cambridge.org/core/product/identifier/S0924933824018017/type/journal_articleanxietycognitivedepressionemotionalresidual symptoms |
| spellingShingle | Michel Danon Daphnée Poupon Philippe Courtet Philip Gorwood Clustering and drivers of symptoms observed at week six after antidepressant treatment in depressed outpatients European Psychiatry anxiety cognitive depression emotional residual symptoms |
| title | Clustering and drivers of symptoms observed at week six after antidepressant treatment in depressed outpatients |
| title_full | Clustering and drivers of symptoms observed at week six after antidepressant treatment in depressed outpatients |
| title_fullStr | Clustering and drivers of symptoms observed at week six after antidepressant treatment in depressed outpatients |
| title_full_unstemmed | Clustering and drivers of symptoms observed at week six after antidepressant treatment in depressed outpatients |
| title_short | Clustering and drivers of symptoms observed at week six after antidepressant treatment in depressed outpatients |
| title_sort | clustering and drivers of symptoms observed at week six after antidepressant treatment in depressed outpatients |
| topic | anxiety cognitive depression emotional residual symptoms |
| url | https://www.cambridge.org/core/product/identifier/S0924933824018017/type/journal_article |
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