Brain Sciences (Dec 2020)

Treatment-Resistant Depression in a Real-World Setting: First Interim Analysis of Characteristics, Healthcare Resource Use, and Utility Values of the FondaMental Cohort

  • Antoine Yrondi,
  • Djamila Bennabi,
  • Emmanuel Haffen,
  • Delphine Quelard,
  • Ludovic Samalin,
  • Julia Maruani,
  • Etienne Allauze,
  • Damien Pierre,
  • Thierry Bougerol,
  • Vincent Camus,
  • Thierry D’Amato,
  • Olivier Doumy,
  • Jérôme Holtzmann,
  • Christophe Lançon,
  • Fanny Moliere,
  • Rémi Moirand,
  • Isabel Nieto,
  • Raphaëlle Marie Richieri,
  • Mathilde Horn,
  • Laurent Schmitt,
  • Florian Stephan,
  • Jean-Baptiste Genty,
  • Guillaume Vaiva,
  • Michel Walter,
  • Philippe Courtet,
  • Marion Leboyer,
  • Pierre-Michel Llorca,
  • Sophie Marguet,
  • Nathalie Dennis,
  • Dominique Schaetz,
  • Wissam El-Hage,
  • Bruno Aouizerate

DOI
https://doi.org/10.3390/brainsci10120962
Journal volume & issue
Vol. 10, no. 12
p. 962

Abstract

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Background: Major depressive disorder (MDD) is among the most common psychiatric disorders. One-third of patients are usually unresponsive to several lines of treatment. This study aimed to describe the FondaMental French cohort of patients with treatment-resistant depression (TRD) and to estimate utility and healthcare resource use outcomes. Methods: Patients with TRD were evaluated prospectively over four years (baseline, 6, 12, 18, 24, 36 and 48 months) in a real-world clinical setting. Interim analyses focused on the first two consecutive years. Four MDD-related states (major depressive episode (MDE), response, remission, recovery) were defined based on the MADRS (Montgomery–Åsberg depression rating scale) and other clinical events. Health status was assessed with the EuroQol 5 Dimensions 5 Level (EQ-5D-5L) questionnaire. Utility values were estimated as preference measures that the patients assigned to their overall health status. Results: This study was based on 252 patients with TRD. The mean utility value by health state was 0.41, 0.63, 0.80, and 0.90, for MDE, response, remission, and recovery, respectively. At baseline, 59% of patients had an MADRS score of at least 28. Their baseline average utility value was lower compared to the other patients (0.43 versus 0.58, p < 0.001). This significant difference persisted at the following visits. The rate of patients in MDEs having at least one hospitalisation for depression or other reasons than depression was generally higher than that in the other health states. Conclusion: This study documented patterns in healthcare resource consumption, quality of life, and other characteristics in patients with TRD, both globally and by health state and depression severity.

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