PATIENT-REPORTED OUTCOMES OF QUALITY OF LIFE, FUNCTIONING, AND DEPRESSIVE SYMPTOM SEVERITY IN MAJOR DEPRESSIVE DISORDER COMORBID WITH PANIC DISORDER BEFORE AND AFTER SSRI TREATMENT IN THE STAR*D TRIAL

• Type of Material: Article
• Authors: Waguih William IsHak, Cedars-Sinai Medical Center; James Mirocha, Cedars-Sinai Medical Center; Scott Christensen, Cedars-Sinai Medical Center; Fan Wu, University of California Los Angeles; Richard Kwock, University of California Los Angeles; Joseph Behjat, University of California Los Angeles; Sarah Pi, University of California Los Angeles; A. Akopyan, University of California Los Angeles; Eric D. Peselow, New York University; Robert Cohen, Emory University; David Elashoff, University of California Los Angeles
• Language: English
• Date: 2014-08-01
• Publisher: Wiley: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2013 Wiley Periodicals, Inc.
• Final Published Version (URL): http://dx.doi.org/10.1002/da.22152
• Title of Journal or Parent Work: Depression and Anxiety
• ISSN: 1091-4269
• Volume: 31
• Issue: 8
• Start Page: 707
• End Page: 716
• Grant/Funding Information: The study was supported by NIMH Contract # N01MH90003 to the University of Texas Southwestern Medical Center.
• Keywords: PSYCHIATRY, SSCI; PRIMARY-CARE; quality of life; PSYCHIATRY, SCI; ANXIETY DISORDERS; IMPAIRMENT; depression; SEQUENCED TREATMENT ALTERNATIVES; Science & Technology; Psychiatry; Psychology; Life Sciences & Biomedicine; SCALE; INDIVIDUAL BURDEN; ILLNESS INDEX; Social Sciences; RATIONALE; Psychology, Clinical; IMPACT; PSYCHOLOGY, CLINICAL; panic attacks/agoraphobia; anxiety/anxiety disorders; DISABILITY; antidepressants
• Research Categories: Health Sciences, Pharmacology; Psychology, Clinical; Health Sciences, Mental Health

Abstract

Background: Panic disorder (PD) is highly comorbid with major depressive disorder (MDD) with potential impact on patient-reported outcomes of quality of life (QOL), functioning, and depressive symptom severity. Methods: Using data from the sequenced treatment alternatives to relieve depression (STAR*D) trial, we compared entry and post-SSRI-treatment QOL, functioning, and depressive symptom severity scores in MDD patients with comorbid PD (MDD+PD) to MDD patients without PD (MDDnoPD). We also compared pre- and posttreatment proportions of patients with severe impairments in quality of life and functioning. Results: MDD+PD patients experienced significantly lower QOL and functioning and more severe depressive symptoms than MDDnoPD patients at entry. Following treatment with citalopram, both groups showed significant improvements, however, nearly 30-60% of patients still suffered from severe quality of life and functioning impairments. MDD+PD patients exited with lower QOL and functioning than MDDnoPD patients, a difference that became statistically insignificant after adjusting for baseline measures of depressive symptom severity, functioning, and QOL, comorbid anxiety disorders (PTSD, GAD, social, and specific phobias), age, and college education. Conclusions: Functional outcomes using QOL and functioning measures should be utilized in treating and researching MDD so that shortfalls in traditional treatment can be identified and additional interventions can be designed to address severe baseline QOL and functioning deficits in MDD comorbid with PD.