Characteristics of the treatments for each severity of major depressive disorder: A real-world multi-site study

Hiroyuki Muraoka, Fumitoshi Kodaka, Naomi Hasegawa, Norio Yasui-Furukori, Kentaro Fukumoto, Hiroko Kashiwagi, Hiromi Tagata, Hikaru Hori, Kiyokazu Atake, Hitoshi Iida, Kayo Ichihashi, Ryuji Furihata, Takashi Tsuboi, Masahiro Takeshima, Hiroshi Komatsu, Chika Kubota, Shinichiro Ochi, Yoshikazu Takaesu, Masahide Usami, Tatsuya NagasawaManabu Makinodan, Toshinori Nakamura, Mikio Kido, Ikki Ueda, Hirotaka Yamagata, Toshiaki Onitsuka, Takeshi Asami, Akitoyo Hishimoto, Kazuyoshi Ogasawara, Eiichi Katsumoto, Kenichiro Miura, Junya Matsumoto, Kazutaka Ohi, Hisashi Yamada, Koichiro Watanabe, Ken Inada, Katsuji Nishimura, Ryota Hashimoto

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: In the treatment guidelines for major depressive disorder (MDD), the recommended treatment differs based on the severity. However, the type of treatment provided based on the severity of MDD in real-world clinical practice has not been investigated. In this study, we clarified the actual situation of MDD treatment in clinical practice and compared the treatment based on the severity of MDD. Methods: We used data from 1484 patients with MDD at discharge from October 2016 to March 2020. Results: The number of psychotropic prescriptions tended to be lower in those diagnosed with MDD in the severe group compared to in the non-severe group. There were significant differences among the three groups (mild, moderate/severe, and psychotic) in the percentage of patients who were not prescribed antipsychotics (p = 1.9 ×10-6), a combination of antipsychotics and antidepressants (p = 5.0 ×10-4), and the implementation rate of modified electroconvulsive therapy (m-ECT) (p = 3.4 ×10-9). The percentage of patients with a severe diagnosis who underwent m-ECT was higher, which corresponded to the severity. Conclusion: Our findings showed that the use of psychotropics decreased when the severity of MDD was diagnosed, and the rate of a combination of antipsychotics and antidepressants and the implementation rate of m-ECT increased with the severity. However, this study suggests that there is still an evidence-practice gap in the treatment of MDD in Japan, and guidelines are only partially adhered to in the treatment of depression.

Original languageEnglish
Article number103174
JournalAsian Journal of Psychiatry
Volume74
DOIs
Publication statusPublished - Aug 2022
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Psychology(all)
  • Psychiatry and Mental health

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