Assessment of quality of life and cognitive dysfunction among patients with Major Depressive Disorder

Introduction Major Depressive Disorder (MDD) is associated with high mortality, disability and morbidity. Studies demonstrated mixed results on effects of depression treatments on quality of life (QOL). Objectives To evaluate the severity of depression among Jordanian patients diagnosed with MDD before and after treatment and to find any relationship between QOL, depression severity and perceived cognitive dysfunction. Methods Patients from both genders, 18-65 years old and diagnosed with MDD were included to attend two visits; at baseline and 6 weeks after treatment, in each they completed three questionnaires: Patient Health Questionnaire (PHQ-9) for depression severity, patient-rated Perceived Deficit Questionnaire (PDQ-5) for cognitive function, and World Health Organization Quality of Life Brief (WHOQOL-BREF) format. Results A total of 92 patients completed the study. The scores of the different questionnaires and their correlations before and after treatment are presented in tables 1 and 2. Correlations between PHQ-9 and PDQ-5 before and after treatment are illustrated in figs 1 and 2, respectively. Table 1: Total scores for WHOQOL-BREF format, PDQ-5 and PHQ-9, before and after treatment Questionnaire Before After P-value General quality of life 2.5±1 3.5±0.7 <0.0001 General health satisfaction 2.3±1 3.4±0.9 <0.0001 Physical health (Domain 1) 10±2.6 13.9±2.6 <0.0001 Psychological (Domain 2) 8±2.3 12.6±2.3 <0.0001 Social relationships (Domain 3) 9±3.2 12.8±2.8 <0.0001 Environment (Domain 4) 12.3±3 14.4±7.5 0.0003 Patient-rated Perceived Deficit 5 (PDQ-5) 13±4.4 7.2±4 <0.0001 Patient health questionnaire 9 (PHQ-9) 19±5.4 7.1±5.1 <0.0001 Values are presented as mean±SD. Analysis: Paired t test. P<0.05 is significant. Table 2: Correlations between total scores for all of the domains for WHOQOL-BREF and PDQ-5, and between WHOQOL-BREF and PHQ-9, before and after treatment Domains/Facets Patient-rated Perceived Deficit 5 (PDQ-5) Patient health questionnaire 9 (PHQ-9) Before (r, p) After (r, p) Before (r, p) After (r, p) General quality of life -0.38, 0.0001 -0.26, 0.01 -0.55, <0.0001 -0.49, <0.0001 General health satisfaction -0.24, 0.02 -0.14, 0.2 -0.51, <0.0001 -0.48, <0.0001 Physical health (Domain 1) -0.37, 0.0003 -0.50, <0.0001 -0.57, <0.0001 -0.76, <0.0001 Psychological (Domain 2) -0.46, <0.0001 -0.43, <0.0001 -0.58, <0.0001 -0.68, <0.0001 Social relationships (Domain 3 -0.37, 0.0002 -0.37, 0.0002 -0.42, <0.0001 -0.40, <0.0001 Environment (Domain 4) -0.52, <0.0001 -0.21, 0.047 -0.36, 0.0004 -0.12, 0.2 Spearman correlation (r); P<0.05 is significant. WHOQOL: World Health Organization Quality of Life. Image: Image 2: Conclusions Significant improvements were found in the symptoms of depression, cognition and QOL in patients with MDD after treatment. Depression severity significantly inversely correlated with QOL and cognition of MDD patients. Disclosure of Interest None Declared

Introduction: Major Depressive Disorder (MDD) is associated with high mortality, disability and morbidity.Studies demonstrated mixed results on effects of depression treatments on quality of life (QOL).
Objectives: To evaluate the severity of depression among Jordanian patients diagnosed with MDD before and after treatment and to find any relationship between QOL, depression severity and perceived cognitive dysfunction.Methods: Patients from both genders, 18-65 years old and diagnosed with MDD were included to attend two visits; at baseline and 6 weeks after treatment, in each they completed three questionnaires: Patient Health Questionnaire (PHQ-9) for depression severity, patient-rated Perceived Deficit Questionnaire (PDQ-5) for cognitive function, and World Health Organization Quality of Life Brief (WHOQOL-BREF) format.Results: A total of 92 patients completed the study.The scores of the different questionnaires and their correlations before and after treatment are presented in tables 1 and 2. Correlations between PHQ-9 and PDQ-5 before and after treatment are illustrated in figs 1 and 2, respectively.Introduction: Low and middle-income countries (LMICs) hold the majority of disease burden attributed to major depressive disorder (MDD).Despite this, there remains a substantial gap for access to evidence-based treatments for MDD in LMICs like Pakistan.Measurement-based care (MBC) incorporates systematic administration of validated outcome measures to guide treatment decision making and is considered a low-cost approach to optimise better clinical outcomes for individuals with MDD but there is a paucity of evidence on the efficacy of MBC in LMICs.
Objectives: This protocol highlights a randomized trial which will include Pakistani outpatients with moderate to severe major depression.
Methods: Participants will be randomised to either MBC (guided by schedule), or standard treatment (guided by clinicians' judgement), and will be prescribed with paroxetine (10-60mg/day) or mirtazapine (7.5-45mg/day) for 24 weeks.Outcomes will be evaluated by raters blind to study protocol and treatment.
Results: National Bioethics Committee (NBC) of Pakistan has given full ethics approval.The trial is being conducted and reported as per recommendation of the CONSORT statement for RCTs.
Conclusions: With increasing evidence from high-income settings supporting the effectiveness of MBC for MDD, it is now necessary to explore its feasibility, utility.and efficacy in low-resource settings.The results of the proposed trial could inform the development of a low-cost and scalable approach to efficiently optimise outcomes for individuals with MDD in Pakistan.
Disclosure of Interest: None Declared

EPV0436
Electroconvulsive therapy vs Esketamine among patients with Major Depressive Episode Introduction: Major depressive disorder is one of the most common and disabling mental disorders.More than 30% of individuals do not achieve remission after several trials of antidepressants and treatment-resistant depression (TRD) is associated with premature mortality.Electroconvulsive therapy (ECT) is considered the goldstandard for TRD treatment,unfortunately it´s underused due to health care barriers and association with adverse cognitive impairment.So, scientists have sought to identify alternative treatments that approach ECT-equivalent efficacy.Trials with Ketamine and more recently with its S-enantiomer (Esketamine) has been made, revealing a rapid and robust antidepressant effect, emerging as an option for TRD treatment.

Table 1 :
Total scores for WHOQOL-BREF format, PDQ-5 and PHQ-9, before and after treatment Values are presented as meanAESD.Analysis: Paired t test.P<0.05 is significant.

Table 2 :
Correlations between total scores for all of the domains for WHOQOL-BREF and PDQ-5, and between WHOQOL-BREF and PHQ-9, before and after treatment Spearman correlation (r); P<0.05 is significant.WHOQOL: World Health Organization Quality of Life.Conclusions: Significant improvements were found in the symptoms of depression, cognition and QOL in patients with MDD after treatment.Depression severity significantly inversely correlated with QOL and cognition of MDD patients.