Montgomery-Åsberg Depression Rating Scale factors in treatment-resistant depression at onset of treatment: Derivation, replication, and change over time during treatment with esketamine.
Int J Methods Psychiatr Res
; 31(4): e1927, 2022 12.
Article
in En
| MEDLINE
| ID: mdl-35749277
ABSTRACT
OBJECTIVE:
Derive and confirm factor structure of the Montgomery-Åsberg Depression Rating Scale (MADRS) in patients with treatment-resistant depression (TRD) and evaluate how the factors evident at baseline change over 4 weeks of esketamine treatment.METHODS:
Two similarly-designed, short-term TRANSFORM trials randomized adults to esketamine or matching placebo nasal spray, each with a newly-initiated oral antidepressant, for 4 weeks (TRANSFORM-1 N = 342 patients; TRANSFORM-2 N = 223 patients). The factor structure of MADRS item scores at baseline was determined by exploratory factor analysis in TRANSFORM-2 and corroborated by confirmatory factor analysis in TRANSFORM-1. Change in MADRS factor scores from baseline (day 1) to the end of the 28-day double-blind treatment phase of TRANSFORM-2 was analyzed using a mixed-effects model for repeated measures (MMRM).RESULTS:
Three factors were identified based on analysis of MADRS items Factor 1 labeled affective and anhedonic symptoms (apparent sadness, reported sadness, lassitude, inability to feel), Factor 2 labeled anxiety and vegetative symptoms (inner tension, reduced sleep, reduced appetite, concentration difficulties), and Factor 3 labeled hopelessness (pessimistic thoughts, suicidal thoughts). The three-factor structure observed in TRANSFORM-2 was verified in TRANSFORM-1. Treatment benefit at 24 h with esketamine versus placebo was observed on all 3 factors and continued throughout the 4-week double-blind treatment period.CONCLUSIONS:
A three-factor structure for MADRS appears to generalize to TRD. All three factors improved over 4 weeks of treatment with esketamine nasal spray.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Depressive Disorder, Treatment-Resistant
/
Ketamine
Type of study:
Clinical_trials
/
Prognostic_studies
Limits:
Adult
/
Humans
Language:
En
Journal:
Int J Methods Psychiatr Res
Journal subject:
PSIQUIATRIA
Year:
2022
Document type:
Article
Affiliation country: