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Cited by 78Treatment of Major DepressionAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesMental Health Treatment and Access

Predicting relapse in major depressive disorder using patient-reported outcomes of depressive symptom severity, functioning, and quality of life in the individual burden of illness index for depression (IBI-D)

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IsHak, Waguih William, Greenberg, Jared M., Cohen, Robert M.·2013·Journal of Affective Disorders
DOI 10.1016/j.jad.2013.05.048PMC PMC4167729
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Abstract

Background Patients with Major Depressive Disorder (MDD) often experience unexpected relapses, despite achieving remission. This study examines the utility of a single multidimensional measure that captures variance in patient-reported Depressive Symptom Severity, Functioning, and Quality of Life (QOL), in predicting MDD relapse.Methods Complete data from remitted patients at the completion of 12 weeks of citalopram in the STAR*D study were used to calculate the Individual Burden of Illness index for Depression (IBI-D), and predict subsequent relapse at six (n=956), nine (n=778), and twelve months (n=479) using generalized linear models.Results Depressive Symptom Severity, Functioning, and QOL were all predictors of subsequent relapse. Using Akaike information criteria (AIC), the IBI-D provided a good model for relapse even when Depressive Symptom Severity, Functioning, and QOL were combined in a single model. Specifically, an increase of one in the IBI-D increased the odds ratio of relapse by 2.5 at 6 months (β=0.921 ± 0.194, z=4.76, p<2 × 10(-6)), by 2.84 at 9 months (β=1.045 ± 0.22, z=4.74, p<2.2 × 10(-6)), and by 4.1 at 12 months (β=1.41 ± 0.29, z=4.79, p<1.7 × 10(-6)).Limitations Self-report poses a risk to measurement precision. Using highly valid and reliable measures could mitigate this risk. The IBI-D requires time and effort for filling out the scales and index calculation. Technological solutions could help ease these burdens. The sample suffered from attrition. Separate analysis of dropouts would be helpful.Conclusions Incorporating patient-reported outcomes of Functioning and QOL in addition to Depressive Symptom Severity in the IBI-D is useful in assessing the full burden of illness and in adequately predicting relapse, in MDD.

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  • Existing TRD definitions fail to take into consideration the social, economic, anamnestic and interpersonal factors which, alone or in combinations, are known to moderate antidepressant response.

    “Further drawbacks of existing TRD defi­ nitions are that they fail to take into consid­ eration the social, economic, anamnestic (e.g., adverse childhood experiences) and interpersonal factors which, alone or in combinations, are known to moderate antidepressant response 1,44,47,71,75-­ 81 .”

    From Treatment‐resistant depression: definition, prevalence, detection, management, and investigational interventions (2023) · cites this paper as [78]

    The Discussion (page unavailable) identifies psychosocial stressors, family history, and illness history as factors associated with relapse after remission. It does not assess TRD definitions or establish that social, economic, childhood-experience, or interpersonal factors moderate antidepressant response. (LLM, conf=0.74)

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  • Patients with remitted major depressive disorder with functional impairment are at higher risk of relapse.

    “Functional impairment and residual symptoms such as emotional blunting are important as research has shown that patients with remitted MDD with functional impairment are at higher risk of relapse (IsHak et al., 2013).”

    From Effectiveness of Vortioxetine on Emotional Blunting in Patients with Major Depressive Disorder with inadequate response to SSRI/SNRI treatment (2021) · cites this paper as IsHak et al., 2013

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Authors
IsHak, W. W., Greenberg, J. M., & Cohen, R. M.
Affiliations
  • Cedars-Sinai Medical Center (US)
  • University of California, Los Angeles (US)
  • Emory University (US)
Corresponding author
IsHak, Waguih William
ORCID
Venue
Journal of Affective Disorders
Publisher
Elsevier BV
Published
2013-10
Volume
151
Issue
1
Pages
59-65
ISSN
0165-0327 (ISSN-L)
DOI
10.1016/j.jad.2013.05.048
PMC
PMC4167729
OpenAlex
W2022886395
Cited by
78
References
36
Citations by year
2026: 5 · 2025: 6 · 2024: 12 · 2023: 7 · 2022: 8 · 2021: 8 · 2020: 4 · 2019: 11 · 2018: 3 · 2017: 6 · 2016: 2 · 2015: 2 · 2014: 3
FWCI
1.71
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Journal of Affective Disorders (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • NIH
  • NIMH (N01MH90003)
  • the University of Texas Southwestern Medical Center (NCT00021528)
Topics
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords
major depressive disorder, recurrence prediction, patient-reported outcomes, depression severity, functioning, quality of life, remitted depression, STAR*D, citalopram, disease burden
MeSH terms
Activities of Daily Living, Adult, Major Depressive Disorder, Female, Humans, Male, Psychiatric Status Rating Scales, Quality of Life, Recurrence, Remission Induction, Risk Factors, Citalopram, Cost of Illness, Antidepressive Agents, Second-Generation, Self Report

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