Serum-Iron and Serum-Albumin in MDD

Background: The importance of biochemical markers such as serum iron and serum albumin in major depressive disorder (MDD) is unclear. We sought to examine the effect of baseline serum iron and serum albumin on depression severity and antidepressant response in MDD. Methods: 308 MDD outpatients (39.5 \ub1 10.4 years; 168 women) enrolled in an 8-week, 20mg, open trial of fluoxetine had serum iron, serum albumin, height and weight measured at baseline. We assessed the relationship of serum iron and albumin levels at baseline to: 1) depression severity at baseline (as measured by the 17-item Hamilton Depression Rating Scale [HAM-D-17] total score), controlling for age, gender, and BMI, and 2) clinical response, controlling for baseline HAM-D-17. Results: In a multiple regression controlling for age, gender and BMI, lower serum albumin levels predicted greater baseline HAM-D-17 scores (p<0.02); serum iron levels did not predict baseline HAM-D-17 scores (p>0.05). Neither baseline serum iron nor serum albumin levels predicted fluoxetine response (p>0.05). Conclusion: In this open trial of fluoxetine in 308 MDD outpatients, serum albumin predicted greater baseline depression severity, but not clinical response. Serum iron, on the other hand, did not significantly predict either baseline depression severity or clinical response. Future studies on the role of these markers in MDD are warranted. 1. Maes M, Van de Vyvere J, Vandoolaeghe E, Bril T, Demedts P, Wauters A, Neels H. Alterations in iron metabolism and the erythron in major depression: further evidence for a chronic inflammatory process. J Affect Disord. 1996; 40:23-33. 2. Van Hunsel F, Wauters A, Vandoolaeghe E, Neels H, Demedts P, Maes M. Lower total serum protein, albumin, and beta- and gamma-globulin in major and treatment-resistant depression: effects of antidepressant treatments. Psychiatry Res. 1996; 65:159-69

Psychosocial functioning during the treatment of major depressive disorder with fluoxetine.

BACKGROUND: Major depressive disorder (MDD) is associated with significant disability, having a profound impact on psychosocial functioning. Therefore, studying the impact of treatment on psychosocial functioning in MDD could help further improve the standard of care. METHODS: Two hundred twenty-two MDD outpatients were treated openly with 20 mg fluoxetine for 8 weeks. The self-report version of the Social Adjustment Scale was administered at baseline and during the final visit. We then tested for the relationships between (1) self-report version of the Social Adjustment Scale scores at baseline and clinical response, (2) nonresponse, response and remission status and overall psychosocial adjustment at end point, (3) the number/severity of residual depressive symptoms and overall psychosocial adjustment at end point in responders, and (4) the time to onset of response and overall psychosocial adjustment at end point. RESULTS: An earlier onset of clinical response predicted better overall psychosocial functioning at end point (P = 0.0440). Responders (n = 128) demonstrated better overall psychosocial adjustment at end point than nonresponders (P = 0.0003), while remitters (n = 64) demonstrated better overall psychosocial adjustment at end point than nonremitted responders (P = 0.0031). In fact, a greater number/severity of residual symptoms predicted poorer overall psychosocial adjustment at end point in responders (P = 0.0011). Psychosocial functioning at baseline did not predict response. CONCLUSIONS: While MDD patients appear equally likely to respond to treatment with fluoxetine, regardless of their level of functioning immediately before treatment, the above results stress the importance of achieving early symptom improvement then followed by full remission of depressive symptoms with respect to restoring psychosocial functioning in MDD

Changes in depressive symptoms and social functioning in the sequenced treatment alternatives to relieve depression study

10.1097/NMD.0b013e31822fcbe2Journal of Nervous and Mental Disease19910807-810JNMD