Gagan Fervaha1, George Foussias2, Hiroyoshi Takeuchi3, Ofer Agid2, Gary Remington2. 1. Schizophrenia Division and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada. Electronic address: gagan.fervaha@utoronto.ca. 2. Schizophrenia Division and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada. 3. Schizophrenia Division and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada.
Abstract
BACKGROUND: Many individuals with major depressive disorder present with prominent motivational deficits; however, the effect of these symptoms on functional outcomes in the illness remains unclear. METHOD: Individuals with major depression who participated in the Sequenced Treatment Alternatives to Relieve Depression study were included in the present investigation (N=1563). Motivational deficits were evaluated using a derived measure from the Hamilton Depression Rating Scale, while functioning was assessed using the Work and Social Adjustment Scale. Subjective outcomes were also evaluated using the Quality of Life Enjoyment and Satisfaction Questionnaire. RESULTS: After treatment with citalopram, over 70% of participants continued to experience some degree of motivational deficits. These deficits were significantly associated with greater functional impairments both globally and in each domain of functioning evaluated. These symptoms were also linked to worse subjective outcomes such as overall life satisfaction and quality of life. Change in the severity of motivational deficits over time was significantly linked with changes in outcome. Motivational deficits continued to demonstrate a significant association with outcomes, even after controlling for potentially confounding variables such as duration of depressive episode and severity of other depressive symptoms. CONCLUSIONS: Motivational deficits are significantly linked to the functional impairment present in many people with major depression, just as they are in other psychiatric illnesses such as schizophrenia. A greater understanding of the underlying mechanisms of these motivational deficits in particular, beyond other depressive symptoms, is critical to the development of strategies aimed at enhancing functional recovery and improved subjective well-being.
BACKGROUND: Many individuals with major depressive disorder present with prominent motivational deficits; however, the effect of these symptoms on functional outcomes in the illness remains unclear. METHOD: Individuals with major depression who participated in the Sequenced Treatment Alternatives to Relieve Depression study were included in the present investigation (N=1563). Motivational deficits were evaluated using a derived measure from the Hamilton Depression Rating Scale, while functioning was assessed using the Work and Social Adjustment Scale. Subjective outcomes were also evaluated using the Quality of Life Enjoyment and Satisfaction Questionnaire. RESULTS: After treatment with citalopram, over 70% of participants continued to experience some degree of motivational deficits. These deficits were significantly associated with greater functional impairments both globally and in each domain of functioning evaluated. These symptoms were also linked to worse subjective outcomes such as overall life satisfaction and quality of life. Change in the severity of motivational deficits over time was significantly linked with changes in outcome. Motivational deficits continued to demonstrate a significant association with outcomes, even after controlling for potentially confounding variables such as duration of depressive episode and severity of other depressive symptoms. CONCLUSIONS:Motivational deficits are significantly linked to the functional impairment present in many people with major depression, just as they are in other psychiatric illnesses such as schizophrenia. A greater understanding of the underlying mechanisms of these motivational deficits in particular, beyond other depressive symptoms, is critical to the development of strategies aimed at enhancing functional recovery and improved subjective well-being.
Authors: Matthew R Bailey; Olivia Goldman; Estefanía P Bello; Muhammad O Chohan; Nuri Jeong; Vanessa Winiger; Eileen Chun; Elke Schipani; Abigail Kalmbach; Joseph F Cheer; Peter D Balsam; Eleanor H Simpson Journal: J Neurosci Date: 2018-01-24 Impact factor: 6.167
Authors: Fernanda S Correia-Melo; Felipe C Argolo; Lucas Araújo-de-Freitas; Gustavo Carneiro Leal; Flávio Kapczinski; Acioly Luiz Lacerda; Lucas C Quarantini Journal: Neuropsychiatr Dis Treat Date: 2017-06-21 Impact factor: 2.570
Authors: Boadie W Dunlop; Jeffrey J Rakofsky; David Mischoulon; Helen S Mayberg; Becky Kinkead; Andrew A Nierenberg; Thomas R Ziegler; Maurizio Fava; Mark H Rapaport Journal: Pers Med Psychiatry Date: 2022-01-12
Authors: Carlijn Wiersema; Richard C Oude Voshaar; Rob H S van den Brink; Hans Wouters; Peter Verhaak; Hannie C Comijs; Hans W Jeuring Journal: Acta Psychiatr Scand Date: 2022-04-29 Impact factor: 7.734
Authors: Susana Da Silva; Areti Apatsidou; Sarah Saperia; Ishraq Siddiqui; Eliyas Jeffay; Aristotle N Voineskos; Zafiris J Daskalakis; Gary Remington; Konstantine K Zakzanis; George Foussias Journal: Front Psychiatry Date: 2018-05-11 Impact factor: 4.157