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DOI: 10.1055/s-0034-1375628
Italian Study on Depressive Disorders (STudio Italiano MAlattia Depressiva, or STIMA-D): A Nationwide Snapshot of the Status of Treatment for Major Depression
Publication History
received 18 March 2014
revised 04 April 2014
accepted 07 April 2014
Publication Date:
20 May 2014 (online)
Abstract
Introduction: Major depression is a worldwide problem and often remains undetected and untreated. Given the low rates of detection plus the need to intervene in a short time, it is important to identify factors which are likely to improve treatment outcomes.
Methods: STIMA-D was designed to provide the profile of patients with major depression in Italy (focusing on pathway to care, patient characteristics, drug therapy and treatment outcomes). The patients enrolled (M/F, aged between 18 and 65) experienced single/multiple episodes of major depression (DSM-IV-TR). Patients with lifetime or current bipolar syndrome or other mental disorders were excluded.
Results: 44 of the 50 invited centers sent data concerning 1 140 patients. The majority of patients were women. Among working individuals, 52.5% of them were absent from work due to depression in the previous 6 months. Recurrent episodes of major depression were very common and were associated with persistence of residual post-episodic symptoms, a family history of mood disorders and presence of anxiety. 59.6% of the patients were treated with monotherapy (SSRI or SNRI), while 19.2% of them were treated with SSRI plus SNRI. Only the 25.5% on monotherapy had a complete response compared to 12.4% of patients on dual therapy.
Discussion: Poor outcomes in major depression have profound implications on patients’ quality of life and cost burden. New pharmacological approaches with novel modes of action are therefore urgently needed.
Supporting Information
- A list of the investigators and participating centers can be found online: http://dx.doi.org/10.1055/
s-0034-1375628
- Supporting Information
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References
- 1 The World Health Organization . The global burden of disease. 2004 update. Table A2: Burden of disease in DALYs by cause, sex and income group in WHO regions, estimates for 2004. Geneva, Switzerland: WHO; 2008. http://www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_full.pdf
- 2 De Girolamo G, Polidori G, Morosini P et al. La prevalenza dei disturbi mentali in Italia. Il progetto ESEMeD-WMH. Epidemiol Psichiatr Soc 2005; 14: 1-100
- 3 Waraich P, Goldner EM, Somers JM et al. Prevalence and incidence studies of mood disorders: a systematic review of the literature. Can J Psychiatry 2004; 49: 124-138
- 4 Fournier JC, DeRubeis RJ, Hollon SD et al. Antidepressant drug effects and depression severity: a patient-level meta-analysis. JAMA 2010; 303: 47-53
- 5 Singleton N, Bumpstead R, O’Brien M et al. Psychiatric morbidity among adults living in private households, 2000. Int Rev Psychiatry 2003; 15: 65-73
- 6 Coyne JC, Schwenk TL, Fechner-Bates S. Nondetection of depression by primary care physicians reconsidered. Gen Hosp Psychiatry 1995; 17: 3-12
- 7 Tiemens BG, Ormel J, Simon GE. Occurrence, recognition, and outcome of psychological disorders in primary care. Am J Psychiatry 1996; 153: 636-644
- 8 Simon GE, Goldberg D, Tiemens BG et al. Outcomes of recognized and unrecognized depression in an international primary care study. Gen Hosp Psychiatry 1999; 21: 97-105
- 9 Egede LE. Failure to recognize depression in primary care: issues and challenges. J Gen Intern Med 2007; 22: 701-703
- 10 Goldberg D, Huxley P. Mental Illness in the Community: The Pathway to Psychiatric Care. London: Tavistock; 1980
- 11 Saver BG, Van-Nguyen V, Keppel G et al. A qualitative study of depression in primary care: missed opportunities for diagnosis and education. J Am Board Fam Med 2007; 20: 28-35
- 12 Meltzer H, Bebbington P, Brugha T et al. The reluctance to seek treatment for neurotic disorders. J Mental Health 2000; 9: 319-327
- 13 Martinotti G, Sepede G, Gambi F et al. Agomelatine versus venlafaxine XR in the treatment of anhedonia in major depressive disorder. J Clin Psychopharmacol 2012; 32: 487-491
- 14 Hickie IB, Rogers NL. Novel melatonin-based therapies: potential advances in the treatment of major depression. Lancet 2011; 378: 621-631
- 15 Di Giannantonio M, Martinotti G. Anhedonia and major depression: the role of agomelatine. Eur Neuropsychopharmacol 2012; 22: S505-S510
- 16 Aguglia E, Minutolo G, Signorelli MS et al. I bisogni non risolti della depressione maggiore. Giorn Ital Psicopat 2011; 17: 328-334
- 17 Biggio G. Basi neurobiologiche e farmacologiche di una innovativa terapia antidepressiva. Giorn Ital Psicopat 2011; 17: 335-340
- 18 Cuijpers P, Sijbrandij M, Koole SL et al. Adding psychotherapy to antidepressant medication in depression and anxiety disorders: a meta-analysis. World Psychiatry 2014; 13: 56-67
- 19 Thase ME, Greenhouse JB, Frank E et al. Treatment of major depression with psychotherapy or psychotherapy-pharmacology combinations. Arch Gen Psychiatry 1997; 54: 1009-1015
- 20 Angst J, Cui L, Swendsen J et al. Major depressive disorder with subthreshold bipolarity in the National Comorbidity Survey Replication. Am J Psychiatry 2010; 167: 1194-1201
- 21 Fava GA, Savron G, Grandi S et al. Cognitive-behavioral management of drug-resistant major depressive disorder. J Clin Psychiatry 1997; 58: 278-282
- 22 Mueller TI, Leon AC, Keller MB et al. Recurrence after recovery from major depressive disorder during 15 years of observational follow-up. Am J Psychiatry 1999; 156: 1000-1006
- 23 Andlin-Sobocki P, Wittchen HU. Cost of affective disorders in Europe. Eur J Neurol 2005; 12: 34-38
- 24 Kind P, Sorensen J. The costs of depression. Int Clin Psychopharmacol 1993; 7: 191-195
- 25 Thomas C, Morris S. Cost of depression among adults in England in 2000. Br J Psychiatry 2003; 183: 514-519
- 26 Stoudemire A, Frank R, Hedemark N et al. The economic burden of depression. Gen Hosp Psychiatry 1986; 8: 387-394
- 27 Gustavsson A, Svensson M, Jacobi F et al. Cost of disorders of the brain in Europe 2010. Eur Neuropsychopharmacol 2011; 21: 718-779