REAL-WORLD STUDY OF PATIENTS WITH TREATMENT-RESISTANT DEPRESSION- ANALYSIS OF A FRENCH MULTICENTER PROSPECTIVE COHORT

Author(s)

Yrondi A1, El-Hage W2, Quelard D3, Bennabi D4, Garnier M5, Belliver F6, Bourgerol T7, Camus V2, D'Amato T8, Doumy O9, Haesebaert F8, Holtzmann J7, Lançon C10, Vignaud P8, Moliere F11, Nieto I6, Richieri RM10, Domenech P12, Mallet L12, Schmitt L1, Stephan F13, Vaiva G14, Walter M13, Llorca PM5, Courtet P11, Leboyer M12, Marguet S15, Dennis N15, Haffen E16, Schaetz D3, Aouizerate B8
1Service de Psychiatrie et de Psychologie Médicale de l’adulte, Centre Expert Dépression Résistante FondaMental, CHRU de Toulouse, Hôpital Purpan, Toulouse, France, 2Clinique Psychiatrique Universitaire, Centre Expert Dépression Résistante FondaMental, Inserm U1253 Imaging and Brain, CHRU de Tours, Tours, France, 3Janssen, Issy-Les-Moulineaux, France, 4Service de Psychiatrie clinique, Centre Expert Dépression Résistante FondaMental, EA 481 Neurosciences, Université de Bourgogne Franche Comté, Besançon, France, 5Service de Psychiatrie de l’adulte B, Centre Expert Dépression Résistante FondaMental, CHU de Clermont-Ferrand, Clermont-Ferrand, France, 6Service de Psychiatrie adulte, Centre Expert Dépression Résistante FondaMental, Hôpital Fernand-Widal, Paris, France, 7Service de Psychiatrie de l’adulte, CS 10217, Centre Expert Dépression Résistante FondaMental, CHU de Grenoble, Hôpital Nord, Grenoble, France, 8Service Universitaire de Psychiatrie adulte, Centre Expert Dépression Résistante FondaMental, Centre Hospitalier Le Vinatier, Bron cedex, France, 9Pôle de Psychiatrie Générale et Universitaire, Centre Expert Dépression Résistante FondaMental, CH Charles Perrens, Bordeaux, France, 10Pôle Psychiatrie, Centre Expert Dépression Résistante FondaMental, CHU La Conception, Marseille, France, 11Département des Urgences et Post-Urgences Psychiatriques, Centre Expert Dépression Résistante FondaMental, CHRU Lapeyronie, Montpellier, France, 12Pôle de Psychiatrie des Hôpitaux Universitaires, Centre Expert Dépression Résistante FondaMental, Hôpital Henri Mondor, Créteil, France, 13Service de Psychiatrie de l’adulte, Centre Expert Dépression Résistante FondaMental, CHU de Brest, Hôpital de Bohars, Bohars, France, 14Service de Psychiatrie adulte, Centre Expert Dépression Résistante FondaMental, CHRU de Lille, Hôpital Fontan 1, Lille, France, 15Amaris, Paris, France, 16Service de Psychiatrie clinique, Centre Expert Dépression Résistante FondaMental, Centre Investigation Clinique 1431-INSERM, EA 481 Neurosciences, Université de Bourgogne Franche Comté, Besançon, France

Presentation Documents

OBJECTIVES: Major depression is among the most frequent psychiatric disorders with a lifetime prevalence of 24% in France. While between 15% and 30% of major depressive episodes (MDE) fail to respond to at least two different antidepressant treatments, data on this specific population of treatment-resistant depression (TRD) patients is scarce. This study aimed to describe TRD patients using a French cohort and to estimate quality of life and healthcare resource use outcomes.

METHODS: The FondaMental cohort is a French prospective cohort of TRD patients. Inclusions began in 2013 and are ongoing in thirteen centers specialised in major depressive disorder. Patients were followed every six months for four years. Four health states (MDE, response, remission, recovery) were defined based on the MADRS (Montgomery-Asberg depression rating scale) and other events (hospitalizations, treatment switching, etc.). Health-related quality of life, using the EQ-5D questionnaire, and healthcare resource use were estimated by health state.

RESULTS: This study was based on 252 TRD patients available from the cohort (63% women, mean age: 53 years, 35% employed). The average MADRS score at baseline was 29, with 26% of patients having a score above 34 (severe depression). The mean duration since the first depressive episode was 18 years. The mean utility value by health state was 0.41, 0.63, 0.80, and 0.90, for MDE, response, remission, and recovery, respectively. Among patients in MDE, 39.6% had at least one hospitalization, with a mean number of hospitalizations of 1.1 every 6 months. Only 4.6% of patients in response had at least one hospitalization and none in the other health states.

CONCLUSIONS: This study is the first prospective cohort study in TRD patients in France. It provides real-world evidence on their characteristics, health-related quality of life, and healthcare resource use. These results can be used in future cost-effectiveness studies.

Conference/Value in Health Info

2018-11, ISPOR Europe 2018, Barcelona, Spain

Value in Health, Vol. 21, S3 (October 2018)

Code

PMH70

Topic

Patient-Centered Research

Topic Subcategory

Health State Utilities, Patient-reported Outcomes & Quality of Life Outcomes

Disease

Mental Health

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