+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Functional Recovery in Major Depressive Disorder: Focus on Early Optimized Treatment

Functional Recovery in Major Depressive Disorder: Focus on Early Optimized Treatment

Primary Care Companion for Cns Disorders 18(5)

This article presents the case that a more rapid, individualized approach to treating major depressive disorder (MDD) may increase the likelihood of achieving full symptomatic and functional recovery for individual patients and that studies show it is possible to make earlier decisions about appropriateness of treatment in order to rapidly optimize that treatment. A PubMed search was conducted using terms including major depressive disorder, early improvement, predictor, duration of untreated illness, and function. English-language articles published before September 2015 were included. Additional studies were found within identified research articles and reviews. Thirty antidepressant studies reporting predictor criteria and outcome measures are included in this review. Studies were reviewed to extract definitions of predictors, outcome measures, and results of the predictor analysis. Results were summarized separately for studies reporting effects of early improvement, baseline characteristics, and duration of untreated depression. Shorter duration of the current depressive episode and duration of untreated depression are associated with better symptomatic and functional outcomes in MDD. Early improvement of depressive symptoms predicts positive symptomatic outcomes (response and remission), and early functional improvement predicts an increased likelihood of functional remission. The approach to treatment of depression that exhibits the greatest potential for achieving full symptomatic and functional recovery is early optimized treatment: early diagnosis followed by rapid individualized treatment. Monitoring symptoms and function early in treatment is crucial to ensuring that patients do not remain on ineffective or poorly tolerated treatment, which may delay recovery and heighten the risk of residual functional deficits.

Please choose payment method:

(PDF emailed within 1 workday: $29.90)

Accession: 057908199

Download citation: RISBibTeXText

PMID: 27835721

Related references

Functional Recovery in Major Depressive Disorder: Providing Early Optimal Treatment for the Individual Patient. International Journal of Neuropsychopharmacology 21(2): 128-144, 2017

Major Depressive Disorder in recovery and neuropsychological functioning: effects of selective serotonin reuptake inhibitor and dual inhibitor depression treatments on residual cognitive deficits in patients with Major Depressive Disorder in recovery. Journal of Affective Disorders 123(1-3): 341-350, 2010

Functional versus syndromal recovery in patients with major depressive disorder and bipolar disorder. Journal of Clinical Psychiatry 76(6): E809-E814, 2015

Augmentation treatment in major depressive disorder: focus on aripiprazole. Neuropsychiatric Disease and Treatment 4(5): 937-948, 2009

Treating to target in major depressive disorder: response to remission to functional recovery. Cns Spectrums 20 Suppl 1: 20-30; Quiz 31, 2016

Symptomatic and Functional Recovery From Major Depressive Disorder in the Ibadan Study of Ageing. American Journal of Geriatric Psychiatry 26(6): 657-666, 2018

A primary care focus on the treatment of patients with major depressive disorder. American Journal of the Medical Sciences 342(4): 324-330, 2011

Computerized cognitive training and functional recovery in major depressive disorder: A meta-analysis. Journal of Affective Disorders 189: 184-191, 2016

Early improvement in depressive symptoms with desvenlafaxine 50 mg/d as a predictor of treatment success in patients with major depressive disorder. Journal of Clinical Psychopharmacology 34(1): 57-65, 2014

A primary care focus on the diagnosis and treatment of major depressive disorder in adults. Journal of Psychiatric Practice 17(5): 340-350, 2012

Double blinding requirement for validity claims in cognitive-behavioral therapy intervention trials for major depressive disorder. Analysis of Hollon S,  et al., Effect of cognitive therapy with antidepressant medications vs antidepressants alone on the rate of recovery in major depressive disorder: a randomized clinical trial. F1000research 4: 639, 2015

Trait and state aspects of harm avoidance and its implication for treatment in major depressive disorder, dysthymic disorder, and depressive personality disorder. Psychiatry and Clinical Neurosciences 58(3): 240-248, 2004

Recovery from major depressive disorder episode after non-pharmacological treatment is associated with normalized cytokine levels. Acta Psychiatrica Scandinavica 134(1): 40-47, 2017

Add-on high frequency deep transcranial magnetic stimulation (dTMS) to bilateral prefrontal cortex in depressive episodes of patients with major depressive disorder, bipolar disorder I, and major depressive with alcohol use disorders. Neuroscience Letters 671: 128-132, 2018

Prognostic value of imbalanced interhemispheric functional coordination in early therapeutic efficacy in major depressive disorder. Psychiatry Research. Neuroimaging 255: 1-8, 2017