A Cross-sectional, Multi-Centric, Non-Interventional Study to Understand the Management Practices of Major Depressive Disorder in India (DMI: Depression Management in India)

Objective: To study clinical presentation of patients with depression and management practices for major depressive disorder (MDD) by healthcare practitioners (HCPs) in India.

Material and Methods: In a multi-centre, cross-sectional registry, healthcare practitioners opined about the clinical presentation of patients with depression and management practices for MDD. Physician's opinion on the efficacy and tolerability of antidepressants was graded on a four-point rating scale (1 = Excellent, 2 = Good, 3 = Average and 4 = Poor) and adverse events were recorded.

Results: Data of 1048 patients with mean age of 42.83 years (n = 1048; M:F ratio 7:3) was analysed. Comorbid medical illness in the form of cardiovascular disease, diabetes, osteoarthritis and musculoskeletal diseases were present in 40.60%, 8.15%, 6.18% and 4.99% patients respectively, while alcohol consumption/substance abuse and smoking history was present in 14.72% and 12.75% patients respectively. Depressed mood most of the day (69.65%) was the most common clinical presentation. Counselling was most commonly (50.48%) practiced non-pharmacological treatment by HCPs. In the pharmacological management, selective serotonin reuptake inhibitors (SSRIs) (73.56%) were the most commonly prescribed medicines. Escitalopram was preferred as monotherapy in 78.04% patients and rated to have "good to excellent" efficacy and tolerability in 99.45% patients. Dizziness, sexual dysfunction, nausea, sedation and insomnia were reported in 4.96%, 2.29%, 1.72%, 1.15%, 1.05% patients respectively.

Conclusion: Many patients with depression have co-morbid medical illnesses. SSRIs are the most commonly prescribed antidepressants for the management of depression. Most of the patients are treated with monotherapy and escitalopram is the preferred monotherapy in most patients with depression.