The meaningful change threshold as measured by the 16-item quick inventory of depressive symptomatology in adults with treatment-resistant major depressive and bipolar disorder receiving intravenous ketamine
| Autor: | Brett D.M. Jones, Joshua D. Rosenblat, Yena Lee, Roger C.M. Ho, Kevin Kratiuk, Rui Ling, Nelson B. Rodrigues, Mehala Subramaniapillai, Rodrigo B. Mansur, Leanna M.W. Lui, Roger S. McIntyre, Orly Lipsitz, Flora Nasri, Hartej Gill, Kayla M. Teopiz |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Psychiatric Status Rating Scales Depressive Disorder Major medicine.medical_specialty Bipolar Disorder business.industry Cost effectiveness medicine.disease Depressive Disorder Treatment-Resistant Psychiatry and Mental health Clinical Psychology Esketamine Mood disorders Internal medicine Humans Medicine Major depressive disorder Ketamine Self Report Bipolar disorder business Treatment-resistant depression Depression (differential diagnoses) medicine.drug |
| Zdroj: | Journal of Affective Disorders. 294:592-596 |
| ISSN: | 0165-0327 |
| Popis: | Objective .To identify a meaningful change threshold (MCT) in depression outcomes in adults with treatment-resistant major depressive disorder (MDD) or bipolar disorder (BD) receiving intravenous ketamine treatment at a community-based mood disorders center. Method .A triangular approach integrating both anchor-based and distributive methods was used to identify meaningful change on the patient-reported Quick Inventory for Depressive Symptoms Self-Report 16-Item (QIDS-SR16) as associated with the Patient Global Impression - Severity (PGI-S). Both the QIDS-SR16 and the PGI-S are self-report measures, and were collected at five timepoints (timepoints were approximately 2-7 days apart). Results .A total of 297 adults with treatment-resistant depression (TRD) as part of either DSM-5-defined MDD or BD were included. The MCT for the QIDS-SR16 revealed that a mean improvement of 3.38 points from baseline was comparable to a 1-point improvement on the PGI-S. Together with an examination of the probability density function, a 3.5-point change is a reasonable MCT (i.e., 1-point PGI-S improvement) for the QIDS-SR16. A 2-point symptomatic improvement on the QIDS-SR16 was associated with no change on the PGI-S. Conclusion .A 3.5-point reduction in the QIDS-SR16 represents a MCT based on the PGI-S for adults with treatment-resistant MDD or BD receiving intravenous ketamine treatment at a community-based mood disorders center. These findings are limited by the post-hoc nature of this analysis and open-label case-series design. Measurement-based care decisions by patients, providers and clinicians, as well as cost/reimbursement decisions should include consideration of meaningful change along with conventional objective outcomes. |
| Databáze: | OpenAIRE |
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