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 Nagasawa; Manabu 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

doi:10.1016/j.ajp.2022.103174

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 journal › Article › peer-review

7 Citations (Scopus)

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 language	English
Article number	103174
Journal	Asian Journal of Psychiatry
Volume	74
DOIs	https://doi.org/10.1016/j.ajp.2022.103174
Publication status	Published - 08-2022
Externally published	Yes

All Science Journal Classification (ASJC) codes

General Psychology
Psychiatry and Mental health

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.ajp.2022.103174

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Muraoka, H., Kodaka, F., Hasegawa, N., Yasui-Furukori, N., Fukumoto, K., Kashiwagi, H., Tagata, H., Hori, H., Atake, K., Iida, H., Ichihashi, K., Furihata, R., Tsuboi, T., Takeshima, M., Komatsu, H., Kubota, C., Ochi, S., Takaesu, Y., Usami, M., ... Hashimoto, R. (2022). Characteristics of the treatments for each severity of major depressive disorder: A real-world multi-site study. Asian Journal of Psychiatry, 74, Article 103174. https://doi.org/10.1016/j.ajp.2022.103174

@article{d9a4b031b0494b0aaa1a4ee71521ead2,

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

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.",

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

note = "Publisher Copyright: {\textcopyright} 2022 The Authors",

year = "2022",

month = aug,

doi = "10.1016/j.ajp.2022.103174",

language = "English",

volume = "74",

journal = "Asian Journal of Psychiatry",

issn = "1876-2018",

publisher = "Elsevier B.V.",

}

Muraoka, H, Kodaka, F, Hasegawa, N, Yasui-Furukori, N, Fukumoto, K, Kashiwagi, H, Tagata, H, Hori, H, Atake, K, Iida, H, Ichihashi, K, Furihata, R, Tsuboi, T, Takeshima, M, Komatsu, H, Kubota, C, Ochi, S, Takaesu, Y, Usami, M, Nagasawa, T, Makinodan, M, Nakamura, T, Kido, M, Ueda, I, Yamagata, H, Onitsuka, T, Asami, T, Hishimoto, A, Ogasawara, K, Katsumoto, E, Miura, K, Matsumoto, J, Ohi, K, Yamada, H, Watanabe, K, Inada, K, Nishimura, K & Hashimoto, R 2022, 'Characteristics of the treatments for each severity of major depressive disorder: A real-world multi-site study', Asian Journal of Psychiatry, vol. 74, 103174. https://doi.org/10.1016/j.ajp.2022.103174

TY - JOUR

T1 - Characteristics of the treatments for each severity of major depressive disorder

T2 - A real-world multi-site study

AU - Muraoka, Hiroyuki

AU - Kodaka, Fumitoshi

AU - Hasegawa, Naomi

AU - Yasui-Furukori, Norio

AU - Fukumoto, Kentaro

AU - Kashiwagi, Hiroko

AU - Tagata, Hiromi

AU - Hori, Hikaru

AU - Atake, Kiyokazu

AU - Iida, Hitoshi

AU - Ichihashi, Kayo

AU - Furihata, Ryuji

AU - Tsuboi, Takashi

AU - Takeshima, Masahiro

AU - Komatsu, Hiroshi

AU - Kubota, Chika

AU - Ochi, Shinichiro

AU - Takaesu, Yoshikazu

AU - Usami, Masahide

AU - Nagasawa, Tatsuya

AU - Makinodan, Manabu

AU - Nakamura, Toshinori

AU - Kido, Mikio

AU - Ueda, Ikki

AU - Yamagata, Hirotaka

AU - Onitsuka, Toshiaki

AU - Asami, Takeshi

AU - Hishimoto, Akitoyo

AU - Ogasawara, Kazuyoshi

AU - Katsumoto, Eiichi

AU - Miura, Kenichiro

AU - Matsumoto, Junya

AU - Ohi, Kazutaka

AU - Yamada, Hisashi

AU - Watanabe, Koichiro

AU - Inada, Ken

AU - Nishimura, Katsuji

AU - Hashimoto, Ryota

PY - 2022/8

Y1 - 2022/8

N2 - 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.

AB - 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.

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UR - http://www.scopus.com/inward/citedby.url?scp=85131377084&partnerID=8YFLogxK

U2 - 10.1016/j.ajp.2022.103174

DO - 10.1016/j.ajp.2022.103174

M3 - Article

C2 - 35661492

AN - SCOPUS:85131377084

SN - 1876-2018

VL - 74

JO - Asian Journal of Psychiatry

JF - Asian Journal of Psychiatry

M1 - 103174

ER -

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

Abstract

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UN SDGs

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