Treatment-Resistant Depression Cohort in Europe
- Conditions
- Depressive Disorder, Treatment-Resistant
- Registration Number
- NCT03373253
- Lead Sponsor
- Janssen-Cilag Ltd.
- Brief Summary
The purpose of this study is to assess the participants socio-demographics and disease-related characteristics, long-term naturalistic treatment patterns and the clinical, social and economic outcomes of routine clinical practice in the treatment of participants with treatment-resistant depression (TRD) in a variety of European countries.
- Detailed Description
This TRD cohort study will collect critically important data from routine clinical practice in Europe which will further substantiate the understanding of TRD in European clinical practice, with the aim of improving guidance and informing the development of better treatment strategies for this medically important condition. All data recorded in the case report form (CRF) should be documented in participants' medical records, that will be the primary data source of each participant. Participants who meet the diagnostic criteria for Major Depressive Disorder (MDD) and the diagnostic criteria for TRD, and are initiating or planned to initiate a new antidepressive treatment regimen will participate in the study. The end of the entire study will be 6 months after enrollment of the last participant in the study.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 830
- Meets the diagnostic criteria for single episode or recurrent MDD, without psychotic features, according to either the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) or the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)
- Is considered to suffer from a moderate or severe depressive syndrome, as defined by a Montgomery-Asberg Depression Rating Scale (MADRS) total score greater than or equal to (>=) 20 at baseline
- Meets/has met the TRD criteria, defined as lack of clinically meaningful improvement, as indicated by a Clinical Global Impression-Change (CGI-C) score >= 4 and/or less than or equal to (<=) 25 percent (%) improvement in MADRS total score (lack of tolerability is not an indicator of non-response), with at least 2 different oral antidepressant treatments (of the same class, of a different class, or a combination of antidepressants or antidepressant with adjunctive antipsychotics) in the current episode of depression, prescribed in adequate dosages (as defined in the Massachusetts General Hospital - Antidepressant Treatment Response Questionnaire [MGH ATRQ]) for adequate duration (at least 6 weeks) with adequate treatment adherence assessed by physicians
- Is initiating a new antidepressive treatment to treat the current depressive episode
- Must be capable of providing informed consent, based on the opinion of the participating physician
- Has a current or prior diagnosis of a psychotic disorder, MDD with psychotic features, bipolar or related disorders, or intellectual disability, according to DSM-5 or ICD-10
- Has homicidal ideation/intent or has suicidal ideation with some intent to act, within 1 month prior to enrollment (per the physician's clinical judgment or based on the Columbia-Suicide Severity Rating Scale [C-SSRS] corresponding to a response of "Yes" on Item 4 [active suicidal ideation with some intent to act, without specific plan] or Item 5 [active suicidal ideation with specific plan and intent]) or a history of suicidal behavior within 1 year prior to enrollment
- Has a history of moderate or severe substance use disorder or severe alcohol use disorder according to DSM 5 criteria, except for nicotine and caffeine, within 6 months prior to enrollment
- Has a lifetime history of hallucinogen-related substance use disorder, with ketamine, phencyclidine (PCP), lysergic acid diethylamide (LSD), or 3,4 methylenedioxy-methamphetamine (MDMA)
- Has participated in or is currently enrolled in any clinical trial or observational study within the current episode
- Has previously received esketamine at any time
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Number of Treatment Resistant Depression (TRD) Participants With Change From Baseline in Socio-demographic Characteristics Baseline up to 21 months (end of study) Number of TRD participants with change from baseline in socio-demographic characteristics (education, occupational status, living status, economic status, marital status, legal status) will be assessed.
Treatment Patterns Over Time for TRD Participants Baseline up to 21 months (end of study) Treatment patterns (pharmacological and/or non-pharmacological) of TRD participants will be assessed over time.
Percentage of Participants With Disease-Related Characteristics Up to 21 months Percentage of participants with disease-related characteristics for TRD among Major Depressive Disorder (MDD) participants will be assessed.
Severity of Symptoms as Measured by Montgomery-Asberg Depression Rating Scale (MADRS) Up to 21 months The MADRS is a clinician-rated scale designed to measure changes in depression severity due to antidepressant treatment.The MADRS consists of 10 items, each of which is scored from 0 (item not present or normal) to 6 (severe or continuous presence of the symptoms) for a total possible score of 60. Higher scores represent a more severe condition.
Participant's Clinical Global Impression-Severity (CGI-S) Score Up to 21 months The CGI-S evaluates the severity of psychopathology on a scale of 0 to 7. Considering total clinical experience, a participant is assessed on severity of mental illness at the time of rating according to: 0=not assessed; 1=normal (not at all ill); 2=borderline mentally ill; 3=mildly ill; 4=moderately ill; 5=markedly ill; 6=severely ill; 7=among the most extremely ill participants. The CGI-S permits a global evaluation of the participant's condition at a given time.
Participant's Clinical Global Impression-Change Scale (CGI-C) Up to 21 months The CGI-C is a clinician-rated 7 point scale, ranging from 1 (very much improved) to 7 (very much worse). The CGI C scale will be used in this study to assess any improvement or worsening in a participant's condition versus previous assessments.
Healthcare Resource Utilization in TRD Participants Up to 21 months Healthcare resources utilized in TRD participants will be estimated.
European Quality of Life (EuroQol) 5-Dimension 5-Level Questionnaire Up to 21 months The EQ-5D-5L descriptive system comprises 5 dimensions - mobility, self-care, usual activities, pain/discomfort, and anxiety/depression - each of which is divided into 5 levels of perceived problems (Level 1 indicating no problem, Level 2 indicating slight problems, Level 3 indicating moderate problems, Level 4 indicating severe problems, and Level 5 indicating extreme problems).
Quality of Life in Depression Scale (QLDS) Up to 21 months The QLDS is a disease-specific PRO used to document the impact that depression has on a participant's quality of life. The QLDS is a 34-item self-rated questionnaire consisting of dichotomous response questions, with responses being either True/Not True or Yes/No. It is scored binomially (that is, 0 or 1), with high scores on the QLDS indicating a lower quality of life.
Work Productivity and Activity Impairment (WPAI) Up to 21 months The WPAI produces 4 types of scores: absenteeism (work time missed), presenteeism (impairment at work/reduced on-the-job effectiveness), work productivity loss (overall work impairment/absenteeism plus presenteeism), and activity impairment. The WPAI outcomes are expressed as impairment percentages, with higher numbers indicating greater impairment and less productivity, that is, worse outcomes.
Level of Disability as Sheehan Disability Scale (SDS) Up to 21 months Participant-reported outcome of functional impact and associated disability will be documented by use of the SDS, a 5-item questionnaire. The first 3 items of the SDS document disruption of work/school, social life, and family life/home responsibilities, each using a rating from 0 to 10. The scores for the first 3 items are summed to create a total score of between 0 and 30, a higher score indicative of greater impairment. It also has 1 item on days lost from school or work and 1 item on days when underproductive.
Sequence of Treatments in Participants with TRD Up to 21 months Treatment sequences for participants with TRD within routine clinical care in Europe will be assessed.
Demographic Characteristics of TRD Participants Baseline Demographic characteristics (such as age and gender) of TRD participants will be assessed at baseline.
Suicidality Risk (Ideation and Attempts) as Measured by Columbia-Suicide Severity Rating Scale (C-SSRS) Score Baseline Suicidal ideation or behavior will be measured using C-SSRS score. C-SSRS is a clinician rated assessment of suicidal behavior and/ or intent. Scale consists of 28 items in 4 sections: suicide behavior, actual attempts, suicidal ideation, and intensity of ideation. Suicidal ideation consists of 5 yes/no items: wish to be dead, non-specific active suicidal thoughts, active suicidal ideation with any methods (not plan) without intention to act, active suicidal ideation with some intent to act without specific plan, active suicidal ideation with specific plan and intent. Worsening of suicidal ideation was an increase in severity of suicidal ideation from baseline.
- Secondary Outcome Measures
Name Time Method
Trial Locations
- Locations (98)
Royal South Hants Hospital
🇬🇧Southampton, United Kingdom
Vale House
🇬🇧Winsford, United Kingdom
Azienda Socio Sanitaria Territoriale di Monza Presidio San Gerardo
🇮🇹Monza, Italy
Azienda Ospedaliera Universitaria Maggiore della Carità
🇮🇹Novara, Italy
Azienda Ospedaliero Universitaria Pisana
🇮🇹Pisa, Italy
Azienda Ospedaliera Città della Salute e della Scienza di Torino
🇮🇹Torino, Italy
Azienda Ospedaliero Univ. Policlinico Gaspare Rodolico
🇮🇹Catania, Italy
Azienda Ospedaliero Universitaria San Martino
🇮🇹Genova, Italy
Institute of Psychiatry
🇬🇧London, United Kingdom
Kingfisher Court
🇬🇧Radlett, United Kingdom
Westhaven Hospital
🇬🇧Weymouth, United Kingdom
ASST Fatebenefratelli Sacco
🇮🇹Milano, Italy
Policlinico Universitario Agostino Gemelli
🇮🇹Roma, Italy
AUSL LE di Lecce
🇮🇹Lecce, Italy
Psy Pluriel-Pastur
🇧🇪Bruxelles, Belgium
Psychiatrisch Centrum Dr Guislain
🇧🇪Gent, Belgium
Universitatsklinikum Carl Gustav Carcus Dresden
🇩🇪Dresden, Germany
Klinikum der Johann Wolfgang Goethe -Universitaet
🇩🇪Frankfurt, Germany
Universitaetsklinikum Magdeburg A.oe.R
🇩🇪Magdeburg, Germany
Clinique Saint Pierre
🇧🇪Ottignies, Belgium
Klinikum Chemnitz gGmbH
🇩🇪Chemnitz, Germany
Kliniken Essen-Mitte
🇩🇪Essen, Germany
Universitatsmedizin der Johannes Gutenberg Universitat Mainz
🇩🇪Mainz, Germany
Medizinisches Versorgungszentrum Mittweida - Germany
🇩🇪Mittweida, Germany
Praxis Kuehn
🇩🇪Oranienburg, Germany
Zentrum f. Neurologisch- Psychiatrische Studien und Begutachtung
🇩🇪Siegen, Germany
C.H.U. Brugmann
🇧🇪Bruxelles, Belgium
CHU Sart Tilman
🇧🇪Liège, Belgium
Klinik f. Psychiatrie, Psychosomatik u Psychoth
🇩🇪Bamberg, Germany
Praxis Dr. med. Jana Thomsen
🇩🇪Berlin, Germany
Charite Campus Benjamin Franklin
🇩🇪Berlin, Germany
Alexander Schulze - Germany
🇩🇪Berlin, Germany
Praxis Dr. med. Kirsten Hahn
🇩🇪Berlin, Germany
Gemeinschaftspraxis F. Neurologie, Psychiatrie Und Psychotherapie Dres. Leonhardt U. Sallach
🇩🇪Gelsenkirchen, Germany
Johanniter Krankenhaus Oberhausen
🇩🇪Oberhausen, Germany
Azienda Ospedaliero Universitaria Consorziale Policlinico di Bari
🇮🇹Bari, Italy
Azienda Ospedaliera Papa Giovanni XXIII
🇮🇹Bergamo, Italy
Policlinico Universitario Germaneto
🇮🇹Catanzaro, Italy
Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico
🇮🇹Milano, Italy
Azienda Ospedaliero Universitaria di Parma
🇮🇹Parma, Italy
Psychiatriepraktijk Helmind
🇳🇱Helmond, Netherlands
Centro Hospitalar do Tâmega e Sousa, EPE - Hospital Padre Americo, Vale do Sousa
🇵🇹Guilhufe - Penafiel, Portugal
Centro de Salud Mental Toscar
🇪🇸Elche, Spain
Hosp Univ Fund Jimenez Diaz
🇪🇸Madrid, Spain
Corporacio Sanitari Parc Tauli
🇪🇸Sabadell, Spain
Hosp. de Zafra
🇪🇸Zafra, Spain
Royal Cornhill Hospital
🇬🇧Aberdeen, United Kingdom
West Park Hospital
🇬🇧Darlington, United Kingdom
Burntwood and Lichfield CMHT
🇬🇧Lichfield, United Kingdom
Hauwaert An
🇧🇪Bilzen, Belgium
AZ Sint-Lucas
🇧🇪Brugge, Belgium
St-Andries Ziekenhuis
🇧🇪Tielt, Belgium
Fliedner Klinik Berlin
🇩🇪Berlin, Germany
Asklepios Klinik Nord - Ochsenzoll
🇩🇪Hamburg, Germany
Privat-Nervenklinik, Dr. med. Kurt Fontheim - Germany
🇩🇪Liebenburg, Germany
NPZR - Neuropsychatrisches Zentrum Riem
🇩🇪Muenchen, Germany
Danuvius Klinik GmbH Pfaffenhofen
🇩🇪Pfaffenhofen, Germany
Somni Bene GmbH
🇩🇪Schwerin, Germany
Casa di Cura Villa Von Siebenthal
🇮🇹Genzano di Roma, Italy
Azienda Ospedaliera Universitaria Policlinico G. Martino
🇮🇹Messina, Italy
Umberto I Pol. di Roma-Università di Roma La Sapienza
🇮🇹Rome, Italy
Hospital de Braga
🇵🇹Braga, Portugal
Centro Hospitalar e Universitário de Coimbra, EPE
🇵🇹Coimbra, Portugal
Hosp. Univ. de Bellvitge
🇪🇸Barcelona, Spain
Hosp. Gral. de Ciudad Real
🇪🇸Ciudad Real, Spain
Hosp. Puerta Del Sur
🇪🇸Mostoles, Spain
Hospital Psiquiátrico Provincial Rebullón
🇪🇸Pontevedra, Spain
Surrey and Borders Partnership NHS Foundation Trust
🇬🇧Chertsey, United Kingdom
Barnes-jewish Hospital
🇬🇧London, United Kingdom
Cornwall Learning Disabilities Service
🇬🇧Truro, United Kingdom
Royal Edinburgh Hospital
🇬🇧Edinburgh, United Kingdom
Berrywood Hospital
🇬🇧Northampton, United Kingdom
Hôpital du Petit Bourgogne
🇧🇪Liege, Belgium
Praxis Dipl.-med. Stefan Kusserow
🇩🇪Stralsund, Germany
Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia Presidio Spedali Civili
🇮🇹Brescia, Italy
Azienda Sanitaria 3 Genovese
🇮🇹Genova, Italy
Azienda Ospedaliero Universitaria Ospedali Riuniti
🇮🇹Torrette Di Ancona, Italy
MAPTA Psychiatrie
🇳🇱Zeist, Netherlands
Centro Hospitalar do Baixo Vouga E P E Unidade de Aveiro
🇵🇹Aveiro, Portugal
Unidade Local de Saúde do Baixo Alentejo, EPE
🇵🇹Beja, Portugal
Uls Santo Antonio - Hosp. Magalhaes Lemos
🇵🇹Porto, Portugal
Consulta Dr Salvador Sarro
🇪🇸Barcelona, Spain
Hosp. Univ. de Gran Canaria Dr. Negrin
🇪🇸Las Palmas de Gran Canaria, Spain
Hosp. Univ. I Politecni La Fe
🇪🇸Valencia, Spain
Royal Derby Hospital
🇬🇧Derby, United Kingdom
Praktijk voor Psychiatrie en Psychotherapie
🇳🇱Heerde, Netherlands
Fund. Champalimaud
🇵🇹Lisboa, Portugal
Centro Salud Mental La Corredoria
🇪🇸Oviedo, Spain
Hosp. Univ. de Torrevieja
🇪🇸Torrevieja, Spain
Azienda ospedaliera Sant'Andrea di Roma- Università di Roma La Sapienza
🇮🇹Roma, Italy
Dipartimento Interaziendale di Salute Mentale
🇮🇹Siena, Italy
Centro Hospitalar de Leiria
🇵🇹Leiria, Portugal
Hospital CUF Inf. Santo
🇵🇹Lisboa, Portugal
Hospital do Espirito Santo, EPE
🇵🇹Évora, Portugal
Hosp. Del Mar
🇪🇸Barcelona, Spain
Hosp Clinic de Barcelona
🇪🇸Barcelona, Spain
Csm Fuencarral
🇪🇸Madrid, Spain
University of Bristol
🇬🇧Bristol, United Kingdom