Treatment-Resistant Depression in Argentina: results from a longitudinal analysis of the TRAL Study

Christian Lupo, Gerardo García Bonetto, Ricardo Marcelo Corral, Manuel Vilapriño Duprat, Hernán Alessandria, Gabriela Kanevsky, Sergio Perocco
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Abstract

Literature concerning patients with Treatment-Resistant Depression (TRD) treatment response and patient report outcomes (PROs) -such as QoL or disability- in Argentina is scarce. In the scope of the Treatment-Resistant Depression in America Latina (TRAL) study which previous results highlighted the burden of TRD compared to non-TRD patients as well as essential epidemiological data in the region, this paper reports on the outcomes of Standard-of-Care (SOC) over a 1-year follow-up of TRD patients in the subsample for Argentina. From a sample of 220 MDD patients identified in 5 sites in Argentina, 72 patients were diagnosed with TRD. Exclusion criteria included patients with psychosis, schizophrenia, bipolar disorder, schizoaffective disorder, dementia, with severe chemical dependence or currently participating in another clinical trial. MADRS, PHQ-9 and PROs (EQ-5D and SDS) were used as outcomes. Patients’ mean age was 54.7 years and 70.3% of the patients were female. Around 61% of the patients achieved a response (reduction of MADRS score ≥ 50%), but over 33% did not achieve a remission (MADRS total score ≤12). Almost 67% of the patients still felt anxious/depressed at the end of the study (EQ-5D), while disruption affected patients in diverse areas -71% in work/school, 69.7% in social life/leisure and 66.6% in their family life/personal responsibilities. The burden of TRD is significant in Argentina, and more effort should be put in the implementation of treatment protocols with better outcomes.

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阿根廷抗药性抑郁症:TRAL研究纵向分析的结果。
阿根廷关于难治性抑郁症患者治疗反应和患者报告结果(如生活质量或残疾)的现有文献很少。根据阿根廷对拉丁美洲难治性抑郁症研究的子样本,该研究的先前结果强调了与无DRT患者相比的TRD负担,以及该地区的基本流行病学数据,本文件报告了护理标准(SOC)在对来自阿根廷5个中心的220名TDM患者样本的DRT患者进行1年随访期间的结果,72名患者被诊断为DRT。排除标准排除了精神病、精神分裂症、躁郁症、精神分裂症情感障碍、痴呆症、严重化学依赖或正在参加另一项临床试验的患者。结果采用MADRS、PHQ-9和PRO(EQ-5D和SDS)。患者平均年龄为54.7岁,70.3%的患者为女性。约61%的患者取得了反应(MADRS总分下降≥50%),但33%以上的患者没有缓解(MADRS总分≤12)。近67%的患者在研究结束时仍然感到焦虑/抑郁(EQ-5D),而这种疾病影响了各个领域的患者:71%在工作/学校,69.7%在社交生活/休闲时间,66.6%在家庭生活/个人责任中。DRT在阿根廷的负担很大,必须更加努力地实施效果更好的治疗方案。
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