Pre-treatment factor structures of the Montgomery and Åsberg Depression Rating scale as predictors of response to escitalopram in Indian patients with non-psychotic major depressive disorder.
Asian J Psychiatr
; 28: 154-159, 2017 Aug.
Article
em En
| MEDLINE
| ID: mdl-28784374
ABSTRACT
BACKGROUND:
Major Depressive Disorder (MDD) is a broad heterogeneous construct resolving into several symptom-clusters by factor analysis. The aim was to find the factor structures of MDD as per Montgomery and Asberg Depression Rating Scale (MADRS) and whether they predict escitalopram response.METHODS:
In a longitudinal study at a tertiary institute in north India, 116 adult out-patients with non-psychotic unipolar MDD were assessed with MADRS before and after treatment with escitalopram (10-20mg) over 6-8 weeks for drug response.RESULTS:
For total 116 patients pre-treatment four factor structures of MADRS extracted by principal component analysis with varimax rotation altogether explained a variance of 57% first factor 'detachment' (concentration difficulty, lassitude, inability to feel); second factor 'psychic anxiety' (suicidal thoughts and inner tension); third 'mood-pessimism' (apparent sadness, reported sadness, pessimistic thoughts) and fourth 'vegetative' (decreased sleep, appetite). Eighty patients (68.9%) who completed the study had mean age 35.37±10.9 yrs, majority were male (57.5%), with mean pre-treatment MADRS score 28.77±5.18 and majority (65%) having moderate severity (MADRS <30). Among them 56 (70%) responded to escitalopram. At the end of the treatment there were significant changes in all the 4 factor structures (p<0.01). Vegetative function was an important predictor of response (p<0.01, odd's ratio 1.3 [1.1-1.6] 95% CI). Melancholia significantly predicted non-response (p=0.04).CONCLUSIONS:
Non-psychotic unipolar major depression having moderate severity in north Indian patients as per MADRS resolved into four factor-structures all significantly improved with adequate escitalopram treatment. Understanding the factor structure is important as they can be important predictor of escitalopram response.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Escalas de Graduação Psiquiátrica
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Citalopram
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Avaliação de Resultados em Cuidados de Saúde
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Inibidores Seletivos de Recaptação de Serotonina
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Transtorno Depressivo Maior
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article