In 2018 Missouri University Psychiatric Center, an inpatient psychiatric hospital established a ketamine infusion team to treat severely depressed and acutely suicidal clients. Over 80 infusions were delivered over three years, with positive outcomes and minimal side effects.

To evaluate outcomes of an inpatient psychiatric intravenous ketamine team to deliver treatment without anesthisia colloabration, which could open the horizon for future intravenous medications in a psychiatric inpatient setting.

A team consisting of a psychiatrist supported by a psychiatric PA, psychiatric pharmacist, and a mental health nurse devloped a protocol including physical and mental health screening, inclusion/exclusion criteria, dosing, and client monitoring. For data collection, the team monitored vital signs and mental status changes for tolerability and depression screening tools for efficacy.

Table 1:

Ketamine Infusion Data

Overall, ketamine infusions were tolerated well with limited adverse drugs reactions reported or observed and were easily addressed by the team without any serious adverse events. Given the rapid improvement of symptoms and overall tolerability, intravenous ketamine infusions conducted solely by a psychiatric-based team advances our field for further treament modalities.

No significant relationships.

Major depressive disorder is present in approximately 7% of the general population. There are some patients that remain treatment-resistant - patients who were treated with two or more different medications and did not demonstrate any improvement in their mental state. These patients can be treated with a new treatment – Esketamine. The recommended Esketamine treatment protocol includes 8-treatment sessions, each session lasts about two hours. In our clinic, we added a therapy group after each treatment. The therapy group is led by two co-therapist and lasts 30 minutes. The patients are invited to share their experiences from the session, their thoughts and emotions.

The study that we will present was conducted in the Esketamine treatment unit at a psychiatric hospital. There were two groups - 1. A group whose treatment included a therapeutic group at the end of each Esketamine treatment (n=30); 2. A group whose treatments did not include a therapeutic group at the end of the Esketamine treatment (n=30).

The current study examines the role of the therapeutic group. It compares between the standard treatment protocol, with and without a therapeutic group. All participants completed three questionnaires, about their emotions, three times during the treatment (before the first session, after 4 sessions and after 8 sessions).

We will present first results as well as vignette to demonstrate.

The expectation is to find a better patient experience and a better insight about the clinical changes following the Esketamine treatment, in the group which participates in the therapy group

No significant relationships.

Depression is known to be associated with changes in the hypothalamic-pituitary-thyroid axis and the brain is a major target organ for thyroid hormone. Overt hypothyroidism can cause symptoms compatible with depression. However, its relationship with subclinical hypothyroidism (SCH) is not well established.

To review the literature regarding the effect of levothyroxine therapy among patients with SCH and coexistent depression.

We conducted a MEDLINE search using depression, subclinical hypothyroidism and levothyroxine as keywords, selecting studies written in English.

SCH is defined as an elevated thyroid stimulating hormone with normal peripheric hormone levels. The association between SCH and depression is controversial. Some studies indicate that SCH had the same propensity with overt hypothyroidism, while others report that major affective symptoms are not associated with SCH, but are likely due to independent psychiatric diagnoses, which are common in the general population and occur with similar frequency in patients with SCH. Individuals with SCH are recommended to initiate levothyroxine replacement therapy only when their TSH level is above 10 mIU/L or if symptoms are present. There is a lack of evidence supporting the use of levothyroxine therapy to improve mental health outcomes and the majority of meta-analysis do not show relief of affective symptoms after levothyroxine therapy, among individuals with SCH.

Routine screening for depressive symptoms among individuals with SCH is important to prevent morbidity. Nevertheless, there is no evidence enduring levothyroxine supplementation in these cases. Further studies, with larger sample sizes and longer follow-up periods are needed to enlighten the potential benefit of this therapy.

No significant relationships.

Postpartum depression (PPD) is an important cause of discomfort and dysfunction that impair the quality of life and the daily functionality not only of the patient but also of her child and her family, in its entirety. New treatment options have been made available for this pathology, but their use is restricted by methodological aspects, like the difficulty of administration, lack of enough data regarding their long-term efficacy, and costs.

To conduct a literature review in order to find the most evidence-based pharmacological interventions for PPD.

A literature review was performed through the main electronic databases (PubMed, CINAHL, SCOPUS, EMBASE) using the search paradigm “postpartum depression” AND “treatment” OR “pharmacological agents”. All papers published between January 2000 and August 2021 were included.

Among the most evidence-based agents for PPD treatment are serotonin selective reuptake inhibitors (SSRIs). As individual agents, sertraline seems to be the most supported antidepressant by evidence from clinical trials, followed by escitalopram/citalopram, and fluoxetine. Other antidepressants supported by clinical data were venlafaxine, desvenlafaxine, nortriptyline, and bupropion. A 6-12 months maintenance treatment is considered optimal after remission, in women with a low risk of recurrence. Brexanolone, zuranolone, and ganaxolone are members of a new class of drugs studied for postpartum depression, but currently, only the first agent is FDA-approved for this indication.

SSRIs are the most supported by evidence treatments for PPD, and brexanolone is a drug with a new mechanism, dedicated to this pathology that provides new hope for recovery.

No significant relationships.

Postpartum depression is a common psychiatric complication after pregnancy, so it is necessary to know the depressive symptoms to be able to carry out early prevention and treatment interventions. It is a health problem with a prevalence that ranges between 10–15% according to the world literature. Behavioral and psychosocial factors favoring postpartum depression are recognized.

-To emphasize multidisciplinary treatment in the combined attention to the mother-baby. -To demostrate decreased risk for baby if early use of antidepressants. -To evaluate of the impact of desvenlafaxine during breastfeeding.

Descriptive-study. Clinical Case. Evolution of postpartum depression. Follow-up of a patient based on coordination with the midwife attending a successful breastfeeding while treatment with desvenlafaxine. Use of Edinburgh Postnatal Depression Scale.

-Use of Desvenlafaxine 50-100mg being compatible with breastfeeding, in adittion to depressive illness improvement *Obstetrics and psychiatry guidelines and safety considerations for lactation and antidepressants).

-Postpartum-depression could be the first episode of depression in a healthy woman. Sometimes there are unnoticed symptoms during pregnancy. -Health-care for puerperal women should be focused on both, biomedical and psychosocial issues, with a coordinated multidisciplinar team. -Due to important early treatment during the puerperium, it is recommended a close medical control of the mother´s psychological state after the birth. -If depression appears, a psychiatric follow-up is kept even after the episode remission. Besides, the role of the midwife is essential during lactation. -Some antidepressants like desvenlafaxine have demonstrated benefits over the risk of the baby´s complications without treatment.

No significant relationships.

Depression is one of the leading causes of psychiatric disability across the globe because of its high prevalence and chronic, treatment resistant and recurrent nature. Erythropoietin (EPO), well known for its effects on blood cells, has also a key role in neuroprotection and cognitive function.

The authors aim to explore the potential of EPO to treat depressive disorders (DD) and related cognitive dysfunction.

A literature research was conducted on PubMed starting from the MeSH terms: “Erythropoietin” and “Depressive Disorders”. The results selected for our analysis corresponded to investigations using EPO based on an adult population with DD.

The research provided 14 results, of which 9 met the defined criteria. Different types of studies with variable samples were considered, including randomized clinical trials (RCTs) and a systematic review. Overall, despite records of reduction in depression symptomatology and increased quality of life, evidence does not demonstrate statistically significant reductions in depression severity through the use of EPO in the treatment of DD. However, several RCTs examined its effect on cognitive performance, founding effective improvements in memory, verbal recall and recognition. The underlying potential mechanisms and the current limitations in the use of EPO, and of the available studies are analysed and discussed.

Although EPO does not appear to be effective treating depression, it may play a role in improvement of deficits in memory and executive function. Larger RCTs evaluating its potential use are needed, in order to move towards better clinical practice, quality of life and functional reintegration of these patients.

No significant relationships.

Acute measles encephalitis is a pathology of the central nervous system. It is most frequent in children but can also be described in adults. Given the rarity of this pathology, we present the case of this patient.

To assess perfectionism and depression and to study the relationship between these two parameters in a population of medical students.

We conducted a descriptive and analytical cross-sectional study among students of the Faculty of Medicine of Sfax during the months of June, July, and August 2020. The data were collected through a self-questionnaire disseminated on the social network “Facebook”.This questionnaire included identification of socio-demographic characteristics as well as the personal history of students. Perfectionism was assessed by the Rheaume scale and depression by the Beck scale.

A total of 206 students participated in the survey. The mean age was 21.49 ± 1.37 years. The majority of students were female (57.2%) with a sex ratio (F/H) of 1.34. Of the participants, 39.8% were enrolled as undergraduates and 60.19% as graduate students. According to their scores on the Rheaume scale, the students were non-perfectionists (NP) in 21.4% of cases; moderately perfectionists (MP) in 70.38% of cases, and highly perfectionists (HP) in 8.25% of cases. Severe depression was objectified in 7.3% of the cases. Students living alone were less perfectionist (p=0.01). Perfectionism score was higher in depressed students (35 ± 6.34) versus (31.428 ± 6.37) with a statistically significant correlation ( p ≤ 0.001).

It is true that perfectionism is an essential element for academic success. However, screening and prevention of depression are deemed necessary given its significant association with perfectionism.

No significant relationships.

There are some patients that remain resistant to treatment for major depressive disorder - who were treated with two or more different medications, and did not demonstrate any improvement in their mental-state. These patients can be treated with a new treatment – Esketamine. The recommended Esketamine treatment protocol includes 8-treatment sessions, each session lasts about two hours. In our clinic, we added a therapy group after each treatment. The therapy group is led by two co-therapist and lasts 30 minutes. The patients are invited to share their experiences from the session.

We will present a case report of a 44 year old man, that suffers from a major-depression for years, with symptoms such as loss of energy, recurrent thoughts of death and a decrease in functioning. He was treated with different medications, but there was no improvement in his mental state.

For the last six months, he was treated with Esketamine and also participated in the therapy group.

According to content that he raised in the sessions of the therapy group and following conversations with him and with his close environment, we observed a clinical improvement in his condition – a positive mood, a decrease of the thoughts of death, an increase in his function at work and at home.

He reported that the improvement is more significant because of the therapy group – he found a peer group, a place to process his treatment experience and to share his feelings and thoughts. We will present vignettes to demonstrate.

No significant relationships.

Hysterical disorders were considered separately in the context of the dynamics of the course of either endogenous affective diseases or schizophrenia, without attention to the conjugation and interaction of issues of hysterical symptoms and affective or psychotic syndromes.

To test the psychopathological structure and provide a typology of the conjugation of hysterical symptoms with other psychopathological syndromes.

120 patients (82 women and 38 men) with schizophrenic and affective disorders with associated hysterical symptoms were examined by a clinical psychopathological method.

Three variants of conjugation were identified. In the group of hysterical disorders associated with affective diseases (37,1%) the structure and dynamics of hysterical symptoms directly influenced the developing affective phase: the low intensity of hysterical symptoms contributed to the development of an apatho-adynamic type of depression, and bright and spontaneous hysterical manifestations formed an anxious-hypochondriac type of depression. Hysterical disorders formed in the structure of the psychotic state (41,4%) influenced the nature, structure, dynamics and content of delusional, hallucinatory and paranoid disorders. “Caste” hysterical symptoms (21,4%) revealed a lack of connection with affective and psychotic states. Hysterical symptoms were characterized by persistence, stability, invariability of manifestations, long-term psychotherapeutic and psychopharmacological resistance.

Clinical and psychopathological analysis of endogenous mental diseases of the affective and schizophrenic spectrum, occurring with hysterical symptoms, showed that the parameter of the conjugation of hysterical symptoms with other psychopathological syndromes is prognostically significant.

No significant relationships.

Approximately 15% of pregnant women suffer from a mental illness, however only half of them accept psychopharmacological treatment. One of the reasons for refusing treatment is the stigma attached to it.An important part of functional recovery is defining identity. This identity is multifactorial and is defined by several variables, one of them being gender.Several studies on motherhood in women with mental illness define the importance of a mothering identity, providing meaning and values. We present the case of a 39-year-old woman, mother of a two-year-old child, undergoing follow-up at a psychiatric clinic for recurrent depressive episodes and a history of two suicide attempts ten years ago. Currently stable in treatment with escitalopram 10 mg and lorazepam 1 mg if necessary.The woman refers the desire to abandon treatment after realizing that she is pregnant again. Therapeutic accompaniment is decided. The social worker from the obstetric service communicates with the psychiatric service to question the woman’s ability to care for a child with her psychiatric history.

Determine the stigma of mental illness, including among healthcare workers.

The woman makes her decision with full judgment. The patient is accompanied during pregnancy without incident, with clinical stability.

After delivery, the patient decides to resume psychopharmacological treatment.

Having a mental illness does not determine a woman’s ability to be a mother. As long as it is agreed with the psychiatrist, patients have the right to make decisions about their treatment.

No significant relationships.

Major depressive disorder (MDD) is a highly prevalent clinical condition with a leading cause of disability worldwide. The currently available therapeutic agents have important limitations regarding side effects, partial or non-responsiveness. Patients are considered to have treatment-resistant depression (TRD) if there is no effect or minimal effectiveness after receiving adequate dose-duration use of antidepressants from two different categories. For this patients, electroconvulsive therapy (ECT) can be a treatment option and new therapies appear to tackle TRD like ketamine, a dissociative anesthetic and analgesic.

The authors elaborate a narrative literature review to understand if ketamine might enhance the antidepressant efficacy of ECT.

PubMed database searched using the terms “Electroconvulsive therapy”, “ketamine” and “treatment-resistant depression”.

ECT is currently recommended as an end-line therapy for TRD. Memory impairment after ECT could be a consequence of indiscriminate activation or saturation of glutamate receptors during the treatment, disrupting hippocampal plasticity involved in memory. Ketamine inhibits N-methyl-d-aspartate (NMDA) receptors, while stimulating glutamate release and was proposed as an ECT adjuvant, might reduce cognitive adverse effects, time until response/ remission and inclusively improve response rates to ECT.

However, response and remission rates of ketamine in ECT showed no significant difference from the comparator groups and was associated with higher rates of psychiatric and cardiovascular adverse events.

The results did not support the use the combination of ketamine and propofol as anesthetic agents for ECT in patients with MDD. However, further studies are needed to investigate the beneficial clinical and cognitive effects of ketamine alone in ECT settings.

No significant relationships.

Psychiatric emergencies in Major Depressive Disorder (MDD) are characterised by multiple types of symptoms including risk of self-harm and suicidal ideation. S-ketamine intranasally (Spravato) has recently been shown to help alleviate symptoms during depressive emergencies. In this case-series, we detail the clinical effects and usability of S-ketamine applied intranasally in a psychiatric emergency setting.

To describe the effects of S-Ketamine on depressive crises associated with suicidality and self-harm in a psychiatric emergency setting.

Patients with MDD in a psychiatric emergency were provided with intranasal S-Ketamine according to clinical indication in routine clinical care in a University inpatient setting. Clinical characteristics were assessed in a standardised manner and symptom measures were applied pre-and posttreatment. Experience with 10 patients is systematically described in this case-series.

Patients had a primary diagnosis of MDD accompanied by a variety of secondary psychiatric comorbidity. Among these 10 patients, the majority were female (70 %) and the mean age was 49.5 yrs (range 26-66). All cases were considered treatment resistant and suffered severe acute suicidal ideation. Across all cases, pre-treatment MADRS was 37 on average (range 20-47) indicating a severe form of MDD. High severity was confirmed in elevated BDI scores (pre-treatment 39). Post-treatment, MADRS scores were reduced to 18 on average, alongside BDI scores (mean 24). S-ketamine administration was well-tolerated and side effects such as dissociation were of short-lived duration.

S-Ketamine intranasally can be safely and effectively administered in an acute psychiatric setting to treat psychiatric emergencies.

BTB received honoraria for consultancy and presentations from AstraZeneca, Bristol-Myers Squibb, Lundbeck, Pfizer, Servier, Wyeth, LivaNova, Janssen, Novartis, Otsuka, Angelini.

Residency training has been reported as being stressful which may lead to different mental disorders.

To study the prevalence and associated factors of anxiety and depression symptoms among psychiatry residents.

A cross-sectional study was conducted through an online survey among psychiatry residents. Participants completed an anonymous self-administered questionnaire and the HADS questionnaire for screening anxiety and depression.

Forty responses were collected.The average age of the sample was 28.08 ± 2.43 and the sex-ratio (F/M) was 0.875. Eleven participants were married. Eight residents were smokers. The prevalence of alcohol use and cannabis use was 22.5 % and 5% respectively. Half of participants were first year residents and near three-quarter of them (72.5%) declared working in poor conditions. A considerable proportion of participants had symptoms of anxiety and depression. The prevalence of anxiety case and depression case was 52.5% and 47.5% respectively. The prevalence of Anxiety symptoms and depression symptoms was significantly higher in female participants (p = 0.017, p=0.034 respectively). Poor conditions of the workplace were significantly associated with depression symptoms (p=0.004).

Training residents in psychiatry showed high rates of anxiety and depression symptoms. Screening and early management of these psychiatric manifestations is necessary. In addition, improving working conditions would upgrade their training and quality of life.

No significant relationships.

To improve the effectiveness of treatment for atypical depression, it is necessary to revise the accumulated experience, taking into account new knowledge and drugs.

Comparative study of the efficacy and safety of therapy for atypical depression (AtD) in the structure of bipolar affective disorder (BAD), recurrent depressive disorder (RDR) and psychogenic depression (PD).

Clinical and clinical follow-up methods examined 77 patients with AtD, of which 35 - with bipolar disorder, 18 - with RDR and 24 - with PD. Patients in all three groups received monotherapy with an antidepressant or a mood stabilizer, or a combination of antidepressant and antipsychotic, antidepressant and mood stabilizer, mood stabilizer and antipsychotic, as well as a combination of antidepressant, antipsychotic and mood stabilizer.

Agomelatine was the most frequently used (27.3%) and effective in reducing MADRS in all groups both in monotherapy and in combination with other drugs. Also in the PD group, escitalopram and vortioxetine were highly effective. Of the antipsychotics, when combined with antidepressants, sulpiride was found to be the most effective. When comparing the tolerance of antidepressants in all groups showed the best results (by the CGI scale), agomelatine and venlafaxine, in the BAR group is also vortioxetine.

The best strategy for effective and safe treatment of atypical depression is the use of modern antidepressant, which does not increase the symptoms of the atypical spectrum and, if necessary, can be supplemented with some antipsychotics.

No significant relationships.

Depression is a leading cause of disability affecting over 300 million indivuals worldwide. About 1/3 of patients with depression fail to achive remission despite treatment with multiple antidepressants and are considered to have treatment-resistant depression (TRD). In view of such facts, vagus nerve stimulation (VNS) therapy was approved as an adjunctive long-term treatment for TRD.

The authors elaborate a narrative literature review about de effectiveness of VNS in treatment for TRD.

PubMed database searched using the terms “treatment-resistant depression”, “vagus nerve stimulation”

The pathophysiology of depression is complex and includes social environmental stress factors, genetic and biological processes, inflammation, and disturbances in monoamine neurotransmission. The overdrive of the HPA axis is most consistently seen in subjects with more severe depression, when the cortisol feedback inhibitory mechanisms are impaired, contributing to cytokine oversecretion. It has been shown that chronic exposure to elevated inflammatory cytokines can lead to depression. The vagus nerve represents the main component of the parasympathetic nervous system, which oversees a vast array of crucial bodily functions, including control of mood and imune response. VNS therapy has a demonstrated anti-inflammatory effect which might be a significant reason for its efficacy in patients who did not respond to antidepressants. Treatments thar target the vagus nerve increase the vagal tone and inhibit cytokine production and the stimulation of vagal aferente fibers in the gut influences monaminergic brain systems.

The mecanismos by which VNS may benefit patients nonresponsive to conventional antidepressants is unclear, with further research need to clarify this.

No significant relationships.

Post-partum depression may occur in the first year after childbirth in approximately 25% of women, at times presenting with psychotic symptoms and catatonic states. Catatonia is a psychomotor syndrome that occurs in association with various neuropsychiatric disorders and can be described according to the characteristics of its manifestation in types such as retarded or agitated.

We report the case of a patient with postpartum depression and catatonic syndrome who, after a session of electroconvulsive therapy, was infected with Sars-COV-2, suspended treatment, and had her condition aggravated with distinct clinical manifestations.

Clinical case report and non-systematic review of articles consulted in the PubMed platform.

A 24-year-old patient develops depressive symptoms and obsessive behaviour 6 months after delivery and deteriorates with mutism, stupor and motor immobility. She was hospitalised and medicated with lorazepam, with no improvement. One session of electroconvulsive therapy was carried out with improvement of the symptoms. Due to an inpatient Covid-19 outbreak, in which the patient was infected, treatment was suspended. During isolation, deterioration of the patient’s condition was observed with psychomotor agitation, bizarre behaviour, and perseverative speech. The patient resumed treatment with ECT, with total remission of the catatonic syndrome and improvement of the affective symptoms.

Catatonic syndromes are relatively rare, but its association with post-partum depression is not so uncommon. The occurrence of different presentations of catatonia, although described as possible in the same episode in the literature, were not found in any clinical studies reviewed, which leads us to conclude that it is an uncommon situation.

No significant relationships.

The lack of a standardised definition for the concept of TRD and an adequate criteria for therapeutic response make difficult the management of patients with MDD who do not achieve remission with one or more courses of treatment. All classifications suggested to define TRD are arbitrary, partially evidence-based, subordinated to the pharmacological findings of the time in which they are written and with serious inconsistencies, making it difficult to construct a universal and enduring diagnostic system.

Considering that the most important goal in treating a patient with Major Depressive Disorder (MDD) should be remission and return to previous functionality, the search for a standardised, evidence-based classification system will allow timely and effective interventions leading to the reduction of this devastating condition.

Bibliographic review

The proposed therapeutic algorithm arises from the combination of several fundamental principles for the management of treatment-resistant depression: the different classification systems of the concept, as well as the concepts of response, relapse, recurrence and remission; the scientific evidence found in the current literature, routine clinical practice, knowledge of switching and augmentation strategies, the new pharmacological targets and neurobiological hypothesis discovered, without forgetting finally the different clinical profiles of depressive symptomatology and the specific indications of each antidepressant.

Resistant depression is difficult to treat successfully and is not a uniform entity. Recently there has been a move to characterise treatment-resistant depression as ‘difficult-to-treat’ depression on the basis that the former description implies that depression treatments are normally effective and that non-response is therefore somehow abnormal.

No significant relationships.

There is overwhelming evidence to show that achieving full remission in depression is important — especially in reducing the indirect costs of depression. Evidence further demonstrates that in primary care, clinicians are not optimising treatments for depression in a timely way —resulting in them not being able to achieve early remission for their clients experiencing depression. Presently, secondary care is unable to provide specialist input for this client cohort.

This project is implementing a model which extends specialist care to primary care. This project assists GP’s through optimising treatments for clients presenting with moderate to severe depression This model uses nurse practitioner led care, with ‘Psynary’, an online system which optimises treatments for moderate to severe depression.

Mixed methods pilot service implementation study, utilising: literature review of published service implementation models; service data gap analysis; qualitative interviews and focus group methodology.

GP and client focus group outcomes, as well as client remission rates in the OptiMA2 trial demonstrate that this healthcare pathway is effective.

The OptiMA2 trial focused on the qualitative analysis of the co-design process to implement the initial care pathway.The OptiMA3 trial will examine the cumulative clinical outcomes to consider if increased rates of remission are achieved and identify potential predictive factors. The long term goal for the system is to support the development of community based care-extender models, including specialist nurses, pharmacists and GPs, to extend specialist mental health expertise to larger primary care populations where the greatest burden of mental illness occurs.

No significant relationships.

1.Introduction MDD is a heterogeneous disorder, with a wide variety of symptoms and inconsistent treatment response, and is not completely understood. A dysregulated stress system is a consistent finding, however, and exhaustion is a consistent trait in adolescent patients. In order to open up our thinking about MDD we take up the challenge to reframe depression, specifically focusing on the possible role of the Microbiota-Gut-Brain-Axis in the etiology of MDD.

We propose a ‘bidirectional feedback hypothesis’: microbiota can promote or inhibit a pro-inflammatory state, (in)directly altering the hypothalamic pituitary adrenal (HPA) axis response and the microbiome and further increasing or decreasing its pro-inflammatory state. The aim is to show that the pro-inflammatory state is an integral part of a HPA axis stress spiralling mechanism that plays a role in the etiology of MDD.

A systematic review based on publications from PubMed, Embase and PsycInfo

The etiology of MDD can be understood as sliding down a spiral. This stress spiralling mechanism can be promoted or inhibited by: 1.factors such as a poor lifestyle or (pre-existing) illness 2.bettering someone’s lifestyle, coping behavior or providing pro-/prebiotics in combination with personalised therapeutics.

We argue that an interdisciplinary One Health approach is the most promising preventive and therapeutic option for MDD.

No significant relationships.

Major depressive disorder (MDD) affects around 10% of the French population annually and significantly impacts patient functioning. Efficacy of vortioxetine was demonstrated in randomised controlled trials, data on its real-world performance is needed.

To describe the effectiveness and safety of vortioxetine in real-world setting from patients enrolled from France in the global RELIEVE study.

RELIEVE was a prospective, multi-national, observational study of outpatients initiating vortioxetine treatment for MDD at physician’s discretion. Data were collected at routine clinical visits. Here we present the outcomes of treatment of patients in France. The primary outcome was functioning measured by SDS. Secondary outcomes included depressive symptoms measured by PHQ-9, cognitive symptoms measured by PDQ-5 and DSST. Changes from baseline to month 6 were estimated with a linear mixed model of repeated measures approach.

A total of 184 patients (mean age, 50.2 years, 65% female, 67.9% of patients had at least one comorbidity) were enrolled from France and included in the analysis. Mean(SD) SDS total score, PHQ-9, PDQ-5 scores at baseline were 21.1(5.4), 17.5(4.7) and 11.7(4.4), the scores(SE) decreased by 10.9(0.59), 9.3(0.48) and 6.1(0.37) from baseline to month 6. Mean(SD) DSST improved from 41.6(15.2) at baseline to 49.1(19.0) at month 6. Safety and tolerability profile of vortioxetine was in line with previous studies.

Sustained improvements in overall functioning, depressive symptoms, cognitive function were observed in patients treated with vortioxetine in a real-world setting, which provided further evidence of effectiveness and safety of vortioxetine in a broad MDD population in France.

M. Rabbani is an employee of Lundbeck France. K. Simonsen and H. Ren are employees of H. Lundbeck A/S.