Nonresponse, partial response, and failure to achieve remission: humanistic and cost burden in major depressive disorder

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Abstract
Objective: To characterize the spectrum of clinical outcomes achieved with depression treatment and the associated impact on quality of life (QOL), functional status, overall well‐being, health‐care costs, and productivity. Sources: Electronic databases including Medline were searched for English language sources between 1995 and 2007 using key words of depression, nonresponse, partial response, and remission and QOL, functional status, utility, cost, and productivity. Study selection: Relevant abstracts were obtained for 488 references and full‐text articles were reviewed that included primary data and compared outcomes by treatment response. Data were abstracted from 26 full‐text articles. Data abstraction: Detailed evidence tables were prepared with the relevant data as well as information on the study design. All data abstracted were checked for accuracy. Synthesis: Treatment remitters and partial responders reported clinically and statistically significant improvements in QOL, functional status, and overall well‐being compared to nonresponders. Annual health‐care costs and productivity losses were significantly lower for remitters and partial responders compared to nonresponders. Conclusions: The reduced disease burden for remitters and partial responders compared to nonresponders indicates that new treatment strategies that improve the rates of response/remission with initial treatment might have value to patients and to society. Depression and Anxiety, 2009.