Major Depressive Disorder with Clinically Relevant Insomnia Symptoms: Healthcare Professional Assessment of Patient Impact and Clinical Management
Major depressive disorder (MDD) is often compounded by clinically relevant insomnia symptoms (MDD-CRIS; warranting clinical attention), causing anxiety, sleep deprivation, and impaired productivity. We assessed the burden (clinical, economic, and personal) of MDD-CRIS on patients through surveying healthcare professionals (HCPs) in the US, Canada, Europe, Brazil, and Australia from October 2023–January 2024.
Respondents: 1) had primary responsibility for managing ≥4 adults with MDD-CRIS (during the last quarter); 2) had practised for 2–35 years; 3) had spent ≥50% of time in clinical settings; 4) were not exclusively managing treatment-resistant patients. The survey included four patient record forms (PRFs) from MDD-CRIS patients who: 1) are not enrolled in clinical trials; 2) are not treatment resistant; 3) could now be deceased.
We present a US/Canada subgroup (n=628 HCPs, yielding 2512 PRFs). MDD-CRIS was rated as having high/severe impact by more HCPs than MDD-mild insomnia (MDD-MIS) for quality of life (80–83% vs 51–58%) and productivity (73–80% vs 47–48%). Approximately 30% of patients were unemployed; employed patients took 18 (US) and 66 (Canada) MDD-and/or-CRIS-related days off/year (average). Overall, ~60% of respondents were moderately satisfied with their treatment strategy; difficulty of treating MDD-CRIS was rated higher than MDD-MIS. Approximately half of patients presented with insomnia as their major concern. Patients treated for CRIS improved clinically, whether treated specifically for insomnia (mean change of 6.1 on Patient Health Questionnaire [PHQ]-9, 5.8 on Hamilton Depression Rating Scale [HAM-D]) or MDD only (5.1 PHQ-9, 5.6 HAM-D).
MDD-CRIS necessitates further research and novel treatments/strategies.
