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In pursuit of full recovery in major depressive disorder

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Abstract

Many individuals with major depression disorder (MDD) who achieve remission of depressive symptoms, do not perceive themselves as fully recovered. This study explores whether clinical remission is related to functional remission and to patient’s perception of recovery, as well as, which factors are associated with their functional and subjective remission. 148 patients with MDD in partial clinical remission were included. Demographics and clinical variables were collected through semi-structured interviews. Objective cognition was evaluated through a neuropsychological battery and subjective cognition through a specific questionnaire. The patient’s psychosocial functioning and the perception of their remission were also assessed. Apart from descriptive analysis, Pearson correlations and backward stepwise regression models explored the relationship between demographic, clinical, and cognitive factors with patients’ functional and self-perceived remission. From the whole sample, 57 patients (38.5%) were considered to achieve full clinical remission, 38 patients (25.7%) showed functional remission, and 55 patients (37.2%) perceived themselves as remitted. Depressive symptoms and objective and subjective executive function were the factors associated with psychosocial functioning. Besides, depressive symptoms, objective and subjective attention, and subjective executive function were the significant explanatory variables for self-perception of remission. The concept of full recovery from an episode of MDD should not only include the clinician’s perspective but also the patient’s psychosocial functioning along with their self-perceived remission. As residual depressive symptoms and cognition (objective and subjective) are factors with great contribution to a full recovery, clinicians should specifically address them when choosing therapeutic strategies.

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Data and code availability

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

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Acknowledgements

We thank the patients who participated in this study. We also thank the staff of the Department of Psychiatry of the Hospital Universitari Parc Taulí for their kind collaboration in patient recruitment.

Funding

This study was supported by Lundbeck España (Institutional ethical committee # 2015630).

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Authors and Affiliations

  1. Sant Pau Mental Health Research Group, Institut d’Investigació Biomèdica Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III (CIBERSAM-ISCIII), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain

    Vicent-Gil M., Trujols J., Portella MJ. & Cardoner N.

  2. ICOnnecta’t E-Health Program, Institut Català d’Oncologia, Hospital Duran I Reynals, Avinguda de La Granvia de L’Hospitalet, 199-203, L’Hospitalet de Llobregat, 08908, Barcelona, Spain

    Serra-Blasco M.

  3. Department of Psychology, Abat Oliba CEU University, Carrer de Bellesguard, 30, 08022, Barcelona, Spain

    Serra-Blasco M.

  4. Mental Health Department, Institut d’Investigació i Innovació Parc Taulí (I3PT), Hospital Universitari Parc Taulí, Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III (CIBERSAM-ISCIII), Universitat Autònoma de Barcelona (UAB), Sabadell, Spain

    Navarra-Ventura G. & Cardoner N.

  5. Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), University of Valencia, Valencia, Spain

    Balanzá-Martínez V.

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Correspondence to Serra-Blasco M..

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Conflict of interest

Dr. Maria J Portella was funded until 2020 by the Ministerio de Ciencia e Innovación of the Spanish Government and by the Instituto de Salud Carlos III through a ‘Miguel Servet-II’ research contract (CPII16-0020), National Research Plan (Plan Estatal de I + D + I 2016-2019), co-financed by the ERDF and by CERCA Programme/Generalitat de Catalunya; she received funding from the Health Research and Innovation Strategic Plan (PERIS) SLT006/17/00177, and honoraria as CME speaker from Pfizer and Lundbeck within the last 3 years. Dr. Narcís Cardoner declares that he has received funding from the Universitat Autònoma de Barcelona, from the Spanish Ministry of Science and Innovation, Instituto Carlos III and from Health Research and Innovation Strategic Plan (PERIS) 2016–2020. He has also received honoraria as consultant, advisor or CME speaker from Janssen, Lundbeck, Pfizer, Exeltis and MSD within the last 3 years. The rest of authors have nothing to disclose.

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M., VG., M., SB., G., NV. et al. In pursuit of full recovery in major depressive disorder. Eur Arch Psychiatry Clin Neurosci 273, 1095–1104 (2023). https://doi.org/10.1007/s00406-022-01487-5

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