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. 2021 Sep 23:17:2995-3006.
doi: 10.2147/NDT.S325954. eCollection 2021.

Patient Expectations and Experiences of Antidepressant Therapy for Major Depressive Disorder: A Qualitative Study

Bernhard T Baune  1   2   3 , Ioana Florea  4 , Bjarke Ebert  5 , Maëlys Touya  6 , Anders Ettrup  5 , Monica Hadi  7 , Hongye Ren  8
Affiliations

Patient Expectations and Experiences of Antidepressant Therapy for Major Depressive Disorder: A Qualitative Study

Bernhard T Baune et al. Neuropsychiatr Dis Treat. .

Abstract

Purpose: This qualitative study explored patient perceptions of the most burdensome symptoms of major depressive disorder (MDD), the impact of symptoms on patients' daily lives, and patient expectations and experiences regarding the timing of onset of antidepressant pharmacotherapy.

Patients and methods: Data were collected through facilitated, patient focus-group sessions in the USA between May and June 2019. Participants were adults with confirmed MDD who reported a major depressive episode within the past 2 years, for which they had received pharmacologic treatment for ≥6 weeks. The semi-structured discussion focused on the key topics of bothersome symptoms of MDD, the impact of symptoms on quality of life, and the effects of antidepressant treatment. Interviews were audio-recorded; findings were summarized using a content-analysis approach.

Results: Five focus-group sessions were undertaken, involving a total of 29 patients (each attended one session; mean age, 43.4 years; 72.4% female). Mean time since confirmed diagnosis of MDD was 13.1 years. The most commonly prescribed antidepressants received were bupropion (41.4% of participants), escitalopram (34.5%), and sertraline (34.5%). The most frequently reported bothersome MDD symptoms were fatigue (mentioned by 58.6% of participants), lack of motivation/loss of interest (51.7%), anxiety/panic (44.8%), sadness (41.4%), and lack of concentration/brain fog (41.4%). Socialization, family life, and work were the areas in which quality of life was most impacted. Participants expressed dissatisfaction with their antidepressant treatment. Fast symptom resolution was mentioned as a priority (defined as <1 week by 38.5% of participants and ≤1 month by 65.4%). Most participants had not experienced fast relief from their symptoms with current or previous antidepressant medications.

Conclusion: Results of this qualitative study suggest that fatigue, anhedonia, cognitive symptoms, and anxiety are some of the most bothersome symptoms for patients with MDD and highlight the importance of obtaining rapid relief from these symptoms in order to improve outcomes and patient satisfaction with antidepressant medication.

Keywords: antidepressant therapy; major depressive disorder; onset of treatment effect; patient experience; quality of life; symptoms.

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Conflict of interest statement

BTB has received speaker/consultation fees from AstraZeneca, Lundbeck, Pfizer, Takeda, Servier, Bristol-Myers Squibb, Otsuka, LivaNova, and Janssen-Cilag. BTB did not receive financial support from H. Lundbeck A/S or other sources for the research presented in this manuscript. IF, BE, AE, and HR are employees of H. Lundbeck A/S. MT is an employee of Lundbeck, USA. MH is an employee of Evidera. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Proportion of participants reporting each of the 22 unique symptom codes identified from the focus-group transcripts.
See this image and copyright information in PMC

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