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Predictors of functional improvement in employed adults with major depressive disorder treated with desvenlafaxine

Lam, Raymond W.a; Endicott, Jeanc; Hsu, Ming-Annd; Fayyad, Ranae; Guico-Pabia, Christinef; Boucher, Matthieub

International Clinical Psychopharmacology:
doi: 10.1097/YIC.0000000000000031
Original Articles
Abstract

We carried out a secondary analysis of a double-blind, placebo-controlled trial of desvenlafaxine for major depressive disorder (MDD) to explore the associations between depressive symptoms and subtypes, and functional outcomes, including work functioning. Employed outpatients with MDD were assigned randomly in a 2 : 1 ratio to receive desvenlafaxine 50 mg/day or placebo for 12 weeks. Analyses were carried out post-hoc with the intent-to-treat (ITT) sample (N=427) and a prospectively defined modified ITT sample (N=310), composed of patients with baseline 17-item Hamilton Rating Scale for Depression score of at least 20. Functional outcomes at week 12 included items and factors from the Montgomery–Åsberg Depression Rating Scale, Sheehan Disability Scale, and the Work Productivity and Activity Impairment questionnaire. In the modified ITT sample, but not in the ITT sample, desvenlafaxine-treated patients showed significantly greater improvement in several functional outcomes in the responder, nonanxious, and normal-energy patient subgroups. Improvement in the 17-item Hamilton Rating Scale for Depression total score at week 2 predicted change at week 12 in several functional outcomes. Functional improvement at 12 weeks was greater in subgroups of patients and was also significantly predicted by early improvement in depressive symptoms in employed patients with MDD treated with desvenlafaxine.

Author Information

aDepartment of Psychiatry, University of British Columbia, Vancouver, British Columbia

bPfizer Canada Inc., Kirkland, Quebec, Canada

cDepartment of Psychiatry, Columbia University, New York, New York

dPfizer Inc., Groton, Connecticut

ePfizer Inc., Collegeville

fCGP Strategic Solutions, LLC, Lansdale, Pennsylvania, USA

Presented as a poster at the United States Psychiatric and Mental Health Congress; San Diego, CA; 8–11 November 2012.

Clinical trials registry number: Available at: http://www.clinicaltrials.gov, NCT00824291.

Correspondence to Raymond W. Lam, MD, FRCPC, Department of Psychiatry, University of British Columbia, 2255 Wesbrook Mall, Vancouver, BC V6T 2A1, Canada Tel: +1 604 822 7325; fax: +1 604 822 7922; e-mail: r.lam@ubc.ca

Received October 11, 2013

Accepted January 27, 2014

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins