PURPOSE: Sociodemographic and socioeconomic characteristics of participants in antidepressant and psychotherapy efficacy trials (AETs and PETs) for major depressive disorder (MDD) may limit the generalizability of the results. We compared trial participants with daily practice patients. We subsequently assessed the influence of socio-demographic and socioeconomic status on treatment outcome in daily practice. METHODS: Data on daily practice patients were derived through routine outcome monitoring (ROM). We included 626 patients with MDD according to the MINIplus. Distributions of age, gender, race, marital status and employment status were compared with participants in 63 selected AETs and PETs. Influence of these features on treatment outcome was explored through multivariate regression analysis. RESULTS: Trial participants were older, more often male (diff. 4 %, p = 0.05), white (diff. 4 %, p < 0.001) and not married (diff. 7 %, p = 0.003). Although significant, most differences were relatively small. However, the difference in employment status was striking: 34 % of the ROM patients were currently working versus 68 % of the trial participants (diff. 34 %, p < 0.001). Being employed contributed to a positive treatment outcome: OR 1.8 for response [50 % reduction of Montgomery Asberg Rating Scale for Depression (MADRS)], OR 1.9 for remission (MADRS ≤10). CONCLUSIONS: Employment status should be taken into account while interpreting results from randomized controlled trials and as predictor of treatment success in daily practice.
PURPOSE: Sociodemographic and socioeconomic characteristics of participants in antidepressant and psychotherapy efficacy trials (AETs and PETs) for major depressive disorder (MDD) may limit the generalizability of the results. We compared trial participants with daily practice patients. We subsequently assessed the influence of socio-demographic and socioeconomic status on treatment outcome in daily practice. METHODS: Data on daily practice patients were derived through routine outcome monitoring (ROM). We included 626 patients with MDD according to the MINIplus. Distributions of age, gender, race, marital status and employment status were compared with participants in 63 selected AETs and PETs. Influence of these features on treatment outcome was explored through multivariate regression analysis. RESULTS: Trial participants were older, more often male (diff. 4 %, p = 0.05), white (diff. 4 %, p < 0.001) and not married (diff. 7 %, p = 0.003). Although significant, most differences were relatively small. However, the difference in employment status was striking: 34 % of the ROM patients were currently working versus 68 % of the trial participants (diff. 34 %, p < 0.001). Being employed contributed to a positive treatment outcome: OR 1.8 for response [50 % reduction of Montgomery Asberg Rating Scale for Depression (MADRS)], OR 1.9 for remission (MADRS ≤10). CONCLUSIONS: Employment status should be taken into account while interpreting results from randomized controlled trials and as predictor of treatment success in daily practice.
Authors: Madhukar H Trivedi; A John Rush; Stephen R Wisniewski; Andrew A Nierenberg; Diane Warden; Louise Ritz; Grayson Norquist; Robert H Howland; Barry Lebowitz; Patrick J McGrath; Kathy Shores-Wilson; Melanie M Biggs; G K Balasubramani; Maurizio Fava Journal: Am J Psychiatry Date: 2006-01 Impact factor: 18.112
Authors: S M Sotsky; D R Glass; M T Shea; P A Pilkonis; J F Collins; I Elkin; J T Watkins; S D Imber; W R Leber; J Moyer Journal: Am J Psychiatry Date: 1991-08 Impact factor: 18.112
Authors: Stephen R Wisniewski; A John Rush; Andrew A Nierenberg; Bradley N Gaynes; Diane Warden; James F Luther; Patrick J McGrath; Philip W Lavori; Michael E Thase; Maurizio Fava; Madhukar H Trivedi Journal: Am J Psychiatry Date: 2009-04-01 Impact factor: 18.112
Authors: Alexander Obbarius; Lisa van Maasakkers; Lee Baer; David M Clark; Anne G Crocker; Edwin de Beurs; Paul M G Emmelkamp; Toshi A Furukawa; Erik Hedman-Lagerlöf; Maria Kangas; Lucie Langford; Alain Lesage; Doris M Mwesigire; Sandra Nolte; Vikram Patel; Paul A Pilkonis; Harold A Pincus; Roberta A Reis; Graciela Rojas; Cathy Sherbourne; Dave Smithson; Caleb Stowell; Kelly Woolaway-Bickel; Matthias Rose Journal: Qual Life Res Date: 2017-08-07 Impact factor: 4.147
Authors: Joshua E J Buckman; Rob Saunders; Laura-Louise Arundell; Iyinoluwa D Oshinowo; Zachary D Cohen; Ciaran O'Driscoll; Phoebe Barnett; Joshua Stott; Gareth Ambler; Simon Gilbody; Steven D Hollon; Tony Kendrick; Edward Watkins; Thalia C Eley; Megan Skelton; Nicola Wiles; David Kessler; Robert J DeRubeis; Glyn Lewis; Stephen Pilling Journal: J Affect Disord Date: 2021-12-14 Impact factor: 6.533