Objective: remission of depression in primary care The Oreon Study.
Identifieur interne : 001985 ( Main/Corpus ); précédent : 001984; suivant : 001986Objective: remission of depression in primary care The Oreon Study.
Auteurs : Marc Ansseau ; Koen Demyttenaere ; Jan Heyrman ; André Migeotte ; Sophie Leyman ; Annick MignonSource :
- European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology [ 1873-7862 ] ; 2009.
English descriptors
- KwdEn :
- Antidepressive Agents (therapeutic use), Depression (drug therapy), Depression (epidemiology), Depression (psychology), Disability Evaluation (MeSH), Female (MeSH), Humans (MeSH), Logistic Models (MeSH), Male (MeSH), Middle Aged (MeSH), Physicians, Family (psychology), Primary Health Care (statistics & numerical data), Psychiatric Status Rating Scales (MeSH), Quality of Life (psychology), Remission, Spontaneous (MeSH), Social Environment (MeSH), Treatment Outcome (MeSH).
- MESH :
- chemical , therapeutic use : Antidepressive Agents.
- drug therapy : Depression.
- epidemiology : Depression.
- psychology : Depression, Physicians, Family, Quality of Life.
- statistics & numerical data : Primary Health Care.
- Disability Evaluation, Female, Humans, Logistic Models, Male, Middle Aged, Psychiatric Status Rating Scales, Remission, Spontaneous, Social Environment, Treatment Outcome.
Abstract
OBJECTIVE
Treatment of depression should result in the absence of symptoms, i.e. remission, in order to restore the functional status of the patient and reduce the risk for relapse. The study assessed the current remission rates in primary care and determined the influencing factors.
METHODS
10 consecutive depressive patients treated by antidepressants for at least 3 months and not more than 12 months were screened by each investigator. Remission rates were defined using the Hamilton-Depression scale 7 items (score of 3 or less) as well as the Carroll self rating scale (score of 7 or less). In addition, patients completed the Sheehan Disability Scale (SDS). Initial severity of depression, type of treatment and socio-economic factors were collected.
RESULTS
292 general practitioners screened a total of 2630 patients. Results indicated low remission rates: 28.3% according to the clinician and 17.1% according to the patient. Absence of remission was associated with higher impairment in work, social and family life. The most frequently reported residual symptoms in nonremitters were general somatic symptoms (92%), depressed mood (92%), psychic anxiety (91%) and impaired work and activities (89%). No differences were observed in remission rates between men and women. Remission rates were significantly lower in patients living alone as compared to those living in couple or family (25.1% vs 30.2%, p=0.03), in patients with lower education (21.3% vs 32.3%, p<0.001), in patients speaking French as compared to Dutch (24.0% vs 34.0% p<0.001), and unemployed patients compared to patients having an occupation (17.1% vs 39.0%, p<0.001). Higher initial severity and number of previous episodes decreased remission rates (p<0.001).
CONCLUSION
This study shows low remission rates in depressed patients treated in general practice. The absence of remission is associated with impairment in work, social and family life. Special attention should be given to identify patients who do not reach remission.
DOI: 10.1016/j.euroneuro.2008.10.003
PubMed: 19144502
Links to Exploration step
pubmed:19144502Le document en format XML
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<author><name sortKey="Ansseau, Marc" sort="Ansseau, Marc" uniqKey="Ansseau M" first="Marc" last="Ansseau">Marc Ansseau</name>
<affiliation><nlm:affiliation>University/CHU de Liège, Department of Psychiatry and Medical Psychology, B-4000 Liège, Belgium. marc.ansseau@chu.ulg.ac.be</nlm:affiliation>
</affiliation>
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<author><name sortKey="Demyttenaere, Koen" sort="Demyttenaere, Koen" uniqKey="Demyttenaere K" first="Koen" last="Demyttenaere">Koen Demyttenaere</name>
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<author><name sortKey="Heyrman, Jan" sort="Heyrman, Jan" uniqKey="Heyrman J" first="Jan" last="Heyrman">Jan Heyrman</name>
</author>
<author><name sortKey="Migeotte, Andre" sort="Migeotte, Andre" uniqKey="Migeotte A" first="André" last="Migeotte">André Migeotte</name>
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<author><name sortKey="Leyman, Sophie" sort="Leyman, Sophie" uniqKey="Leyman S" first="Sophie" last="Leyman">Sophie Leyman</name>
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<author><name sortKey="Mignon, Annick" sort="Mignon, Annick" uniqKey="Mignon A" first="Annick" last="Mignon">Annick Mignon</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en">Objective: remission of depression in primary care The Oreon Study.</title>
<author><name sortKey="Ansseau, Marc" sort="Ansseau, Marc" uniqKey="Ansseau M" first="Marc" last="Ansseau">Marc Ansseau</name>
<affiliation><nlm:affiliation>University/CHU de Liège, Department of Psychiatry and Medical Psychology, B-4000 Liège, Belgium. marc.ansseau@chu.ulg.ac.be</nlm:affiliation>
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<author><name sortKey="Demyttenaere, Koen" sort="Demyttenaere, Koen" uniqKey="Demyttenaere K" first="Koen" last="Demyttenaere">Koen Demyttenaere</name>
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<author><name sortKey="Heyrman, Jan" sort="Heyrman, Jan" uniqKey="Heyrman J" first="Jan" last="Heyrman">Jan Heyrman</name>
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<author><name sortKey="Migeotte, Andre" sort="Migeotte, Andre" uniqKey="Migeotte A" first="André" last="Migeotte">André Migeotte</name>
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<author><name sortKey="Leyman, Sophie" sort="Leyman, Sophie" uniqKey="Leyman S" first="Sophie" last="Leyman">Sophie Leyman</name>
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<author><name sortKey="Mignon, Annick" sort="Mignon, Annick" uniqKey="Mignon A" first="Annick" last="Mignon">Annick Mignon</name>
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<series><title level="j">European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology</title>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Antidepressive Agents (therapeutic use)</term>
<term>Depression (drug therapy)</term>
<term>Depression (epidemiology)</term>
<term>Depression (psychology)</term>
<term>Disability Evaluation (MeSH)</term>
<term>Female (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Logistic Models (MeSH)</term>
<term>Male (MeSH)</term>
<term>Middle Aged (MeSH)</term>
<term>Physicians, Family (psychology)</term>
<term>Primary Health Care (statistics & numerical data)</term>
<term>Psychiatric Status Rating Scales (MeSH)</term>
<term>Quality of Life (psychology)</term>
<term>Remission, Spontaneous (MeSH)</term>
<term>Social Environment (MeSH)</term>
<term>Treatment Outcome (MeSH)</term>
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<keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antidepressive Agents</term>
</keywords>
<keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Depression</term>
</keywords>
<keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Depression</term>
</keywords>
<keywords scheme="MESH" qualifier="psychology" xml:lang="en"><term>Depression</term>
<term>Physicians, Family</term>
<term>Quality of Life</term>
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<keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Primary Health Care</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Disability Evaluation</term>
<term>Female</term>
<term>Humans</term>
<term>Logistic Models</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Psychiatric Status Rating Scales</term>
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<front><div type="abstract" xml:lang="en"><p><b>OBJECTIVE</b>
</p>
<p>Treatment of depression should result in the absence of symptoms, i.e. remission, in order to restore the functional status of the patient and reduce the risk for relapse. The study assessed the current remission rates in primary care and determined the influencing factors.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>METHODS</b>
</p>
<p>10 consecutive depressive patients treated by antidepressants for at least 3 months and not more than 12 months were screened by each investigator. Remission rates were defined using the Hamilton-Depression scale 7 items (score of 3 or less) as well as the Carroll self rating scale (score of 7 or less). In addition, patients completed the Sheehan Disability Scale (SDS). Initial severity of depression, type of treatment and socio-economic factors were collected.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>RESULTS</b>
</p>
<p>292 general practitioners screened a total of 2630 patients. Results indicated low remission rates: 28.3% according to the clinician and 17.1% according to the patient. Absence of remission was associated with higher impairment in work, social and family life. The most frequently reported residual symptoms in nonremitters were general somatic symptoms (92%), depressed mood (92%), psychic anxiety (91%) and impaired work and activities (89%). No differences were observed in remission rates between men and women. Remission rates were significantly lower in patients living alone as compared to those living in couple or family (25.1% vs 30.2%, p=0.03), in patients with lower education (21.3% vs 32.3%, p<0.001), in patients speaking French as compared to Dutch (24.0% vs 34.0% p<0.001), and unemployed patients compared to patients having an occupation (17.1% vs 39.0%, p<0.001). Higher initial severity and number of previous episodes decreased remission rates (p<0.001).</p>
</div>
<div type="abstract" xml:lang="en"><p><b>CONCLUSION</b>
</p>
<p>This study shows low remission rates in depressed patients treated in general practice. The absence of remission is associated with impairment in work, social and family life. Special attention should be given to identify patients who do not reach remission.</p>
</div>
</front>
</TEI>
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<Abstract><AbstractText Label="OBJECTIVE" NlmCategory="OBJECTIVE">Treatment of depression should result in the absence of symptoms, i.e. remission, in order to restore the functional status of the patient and reduce the risk for relapse. The study assessed the current remission rates in primary care and determined the influencing factors.</AbstractText>
<AbstractText Label="METHODS" NlmCategory="METHODS">10 consecutive depressive patients treated by antidepressants for at least 3 months and not more than 12 months were screened by each investigator. Remission rates were defined using the Hamilton-Depression scale 7 items (score of 3 or less) as well as the Carroll self rating scale (score of 7 or less). In addition, patients completed the Sheehan Disability Scale (SDS). Initial severity of depression, type of treatment and socio-economic factors were collected.</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="RESULTS">292 general practitioners screened a total of 2630 patients. Results indicated low remission rates: 28.3% according to the clinician and 17.1% according to the patient. Absence of remission was associated with higher impairment in work, social and family life. The most frequently reported residual symptoms in nonremitters were general somatic symptoms (92%), depressed mood (92%), psychic anxiety (91%) and impaired work and activities (89%). No differences were observed in remission rates between men and women. Remission rates were significantly lower in patients living alone as compared to those living in couple or family (25.1% vs 30.2%, p=0.03), in patients with lower education (21.3% vs 32.3%, p<0.001), in patients speaking French as compared to Dutch (24.0% vs 34.0% p<0.001), and unemployed patients compared to patients having an occupation (17.1% vs 39.0%, p<0.001). Higher initial severity and number of previous episodes decreased remission rates (p<0.001).</AbstractText>
<AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">This study shows low remission rates in depressed patients treated in general practice. The absence of remission is associated with impairment in work, social and family life. Special attention should be given to identify patients who do not reach remission.</AbstractText>
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