Christensen Michael Cronquist, Wong Chiew Meng Johnny, Baune Bernhard T
Medical Affairs, H. Lundbeck A/S, Valby, Denmark.
Biostatistics, Lundbeck Singapore Pte. Ltd., Singapore, Singapore.
Front Psychiatry. 2020 Apr 24;11:280. doi: 10.3389/fpsyt.2020.00280. eCollection 2020.
This analysis was undertaken to examine the relationship between different symptoms of major depressive disorder (MDD) and psychosocial functioning from the perspectives of patients and healthcare providers (HCPs) across the different phases of the disease (acute, post-acute, and remission). Data regarding symptoms of MDD and psychosocial functioning, assessed by an adapted version of the Functioning Assessment Short Test (FAST) scale, were elicited an online survey from 2,008 patients diagnosed with MDD (based on their personal experience of the disease) and 3,138 patients observed by 1,046 HCPs (based on individual patient records). Correlations between patient-reported and HCP-reported MDD symptoms and impairment of psychosocial functioning were assessed by multivariate regression analysis. The population comprised 1,946 patient respondents and 3,042 HCP-reported patients. Patients reported experiencing a wider range of symptoms and greater impairment of functioning than reported by HCPs across all phases of the disease. At the domain level, only cognitive symptoms were found to be significantly associated with functioning during the acute phase from the perspective of patients, while from the HCPs' perspective both mood and cognitive symptoms significantly impacted functioning in this phase. Significant associations were seen between mood, physical, and cognitive symptom domains and functioning in both cohorts during the post-acute and remission phases. Differences in associations between MDD symptoms and functioning were also observed between the two cohorts across all disease phases; in particular, HCPs found that more physical symptoms impacted functioning during remission than did patients. In summary, the results suggest that perceptions of MDD symptoms and the associations between these symptoms and functioning differ significantly between patients and HCPs across all phases of the disease. These findings further highlight the need for improved communication between patients and HCPs in order to set appropriate treatment goals and promote symptomatic and functional recovery in MDD.
本分析旨在从患者和医疗服务提供者（HCPs）的角度，研究重度抑郁症（MDD）不同症状与疾病不同阶段（急性期、急性后期和缓解期）心理社会功能之间的关系。通过功能评估简短测试（FAST）量表的改编版本评估的MDD症状和心理社会功能数据，是通过在线调查从2008名被诊断为MDD的患者（基于他们对疾病的个人体验）和1046名HCPs观察的3138名患者（基于个体患者记录）中获取的。通过多变量回归分析评估患者报告和HCP报告的MDD症状与心理社会功能损害之间的相关性。研究人群包括1946名患者受访者和3042名HCP报告的患者。患者报告在疾病的所有阶段经历的症状范围更广，功能损害比HCPs报告的更严重。在领域层面，从患者的角度来看，仅认知症状在急性期与功能显著相关，而从HCPs的角度来看，情绪和认知症状在此阶段均对功能有显著影响。在急性后期和缓解期，两个队列中情绪、身体和认知症状领域与功能之间均存在显著关联。在所有疾病阶段，两个队列之间也观察到MDD症状与功能之间关联的差异；特别是，HCPs发现，在缓解期，更多的身体症状对功能的影响比患者报告的更大。总之，结果表明，在疾病的所有阶段，患者和HCPs对MDD症状的认知以及这些症状与功能之间的关联存在显著差异。这些发现进一步凸显了改善患者与HCPs之间沟通的必要性，以便设定适当的治疗目标并促进MDD的症状缓解和功能恢复。
