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Influence of sociodemographic and socioeconomic features on treatment outcome in RCTs versus daily psychiatric practice.
MedLine Citation:
PMID:  23212828     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: Sociodemographic and socioeconomic characteristics of participants in antidepressant and psychotherapy efficacy trials (AETs and PETs) for major depressive disorder (MDD) may limit the generalizability of the results. We compared trial participants with daily practice patients. We subsequently assessed the influence of socio-demographic and socioeconomic status on treatment outcome in daily practice. METHODS: Data on daily practice patients were derived through routine outcome monitoring (ROM). We included 626 patients with MDD according to the MINIplus. Distributions of age, gender, race, marital status and employment status were compared with participants in 63 selected AETs and PETs. Influence of these features on treatment outcome was explored through multivariate regression analysis. RESULTS: Trial participants were older, more often male (diff. 4 %, p = 0.05), white (diff. 4 %, p < 0.001) and not married (diff. 7 %, p = 0.003). Although significant, most differences were relatively small. However, the difference in employment status was striking: 34 % of the ROM patients were currently working versus 68 % of the trial participants (diff. 34 %, p < 0.001). Being employed contributed to a positive treatment outcome: OR 1.8 for response [50 % reduction of Montgomery Asberg Rating Scale for Depression (MADRS)], OR 1.9 for remission (MADRS ≤10). CONCLUSIONS: Employment status should be taken into account while interpreting results from randomized controlled trials and as predictor of treatment success in daily practice.
Authors:
R van der Lem; P M Stamsnieder; N J A van der Wee; T van Veen; F G Zitman
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-5
Journal Detail:
Title:  Social psychiatry and psychiatric epidemiology     Volume:  -     ISSN:  1433-9285     ISO Abbreviation:  Soc Psychiatry Psychiatr Epidemiol     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-5     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8804358     Medline TA:  Soc Psychiatry Psychiatr Epidemiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Psychiatry, Leiden University Medical Center/Rivierduinen, Albinusdreef 2, PO Box 9600, 2300 RC, Leiden, The Netherlands, rosalind.van.der.lem@hetdok.nl.
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