Mental Health Centre Northern Zealand, The Early Multimodular Prevention and Intervention Research Institution (EMPIRI) - Mental Health Services CPH, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Frederiksberg, Denmark; Mental Health Centre Copenhagen, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark.
J Affect Disord. 2024 Oct 15;363:112-123. doi: 10.1016/j.jad.2024.07.054. Epub 2024 Jul 17.
Major depressive disorder (MDD) is one of the leading causes of burden of disease globally. We aimed to investigate whether global functioning is impaired in patients with MDD in full or partial remission compared to healthy control individuals (HC).
We conducted a systematic review and meta-analysis according to the PRISMA guideline. We searched the databases PubMed, EMBASE and PsycINFO from January 1st 1980 to February 1st 2023. We included studies of adults with a diagnosis/former diagnosis of MDD with assessment of global functioning performed during a state of full or partial remission. The methodological quality was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist. Standardised mean differences (SMD) using random-effects models were calculated as the summary measure. We further performed meta-analyses of the mean raw score in patients with MDD for individual functioning scales.
Forty-two studies, comprising 17,999 patients with MDD and 35,550 HC, were included, 14 of which included both patients with MDD in full or partial remission and HC. Global functioning was lower in patients with MDD in full or partial remission compared with HC (SMD -2.00, 95 % CI: -0.9 to -3.03, 15 comparisons, I: 99.8 %).
Important information about the study participants and setting was not reported for most studies, or the reporting was unclear.
Patients with MDD have lower levels of functioning compared with HC also when in full or partial remission. Assessment of functioning should be an essential component of managing patients with MDD, also during remission.
重度抑郁症（MDD）是全球疾病负担的主要原因之一。我们旨在研究与健康对照个体（HC）相比，处于完全或部分缓解状态的 MDD 患者的整体功能是否受损。
我们根据 PRISMA 指南进行了系统评价和荟萃分析。我们从 1980 年 1 月 1 日至 2023 年 2 月 1 日，检索了 PubMed、EMBASE 和 PsycINFO 数据库。我们纳入了诊断/既往诊断为 MDD 的成年患者的研究，在完全或部分缓解期间评估整体功能。使用 Joanna Briggs 研究所（JBI）的批判性评估清单评估方法学质量。使用随机效应模型计算标准均数差值（SMD）作为汇总测量。我们进一步对 MDD 患者个体功能量表的平均原始分数进行了荟萃分析。
纳入了 42 项研究，共包含 17999 例 MDD 患者和 35550 例 HC，其中 14 项研究同时包含完全或部分缓解的 MDD 患者和 HC。与 HC 相比，处于完全或部分缓解的 MDD 患者的整体功能较低（SMD -2.00，95%CI：-0.9 至 -3.03，15 项比较，I：99.8%）。
大多数研究未报告或报告不明确有关研究参与者和研究环境的重要信息。
即使在完全或部分缓解期，MDD 患者的功能水平也低于 HC。在管理 MDD 患者时，包括缓解期在内，功能评估应成为重要组成部分。
