Epidemiology and Burden of Treatment-Resistant Depression in Colombia: Analysis of the TRAL Study

Abstract

ObjectivesTo estimate the prevalence of treatment-resistant depression (TRD) in Colombia, and characterize hospitalized major depressive disorder (MDD) patients for disability, health-related quality of life (HRQoL) and work-impairment. Materials and methodsAdult MDD patients (n=162) from 4 centers in Colombia, with a clinical diagnosis of MDD based on DSM-5 and MINI, were consecutively included. Patients with psychosis, schizophrenia, bipolar disorder, schizoaffective disorder, dementia, with severe chemical dependence or currently participating in another clinical trial were excluded. Patient reported outcomes and clinical assessment scales were used as outcomes with WPAI:D (work impairment), EQ-5D (QoL) and Sheehan Disability Scale, as well as healthcare resource utilization. ResultsPrevalence of TRD in Colombia among patients treated at psychiatric reference sites was 32.1% [24.9%; 39.3%], higher in private institutions. Most patients were females and single. 55% reported having moderate to severe problems with usual activities at the beginning of the study. Mean percent of working time missed due to depression was around 53%, and work impairment was roughly 67%. A mean of 2.85 days in the last seven were marked by lost school/work, with higher losses in TRD patients compared to non-TRD. Overall results for HRQoL were lower in TRD patients, but disability and work impairment were higher in non-TRD. ConclusionsThere is a high prevalence of mental disorders in Colombia, including TRD, impacting significantly HRQoL. The burden associated with them may be reduced by a most comprehensive and customized usage of therapies, including the innovations, and implementation of national mental health programs.