Assessment of current clinical practices for major depression in Japan using a web-based questionnaire

Abstract

Purpose

To investigate the current clinical practice of Japanese physicians in the diagnosis and management of major depression (major depressive disorder [MDD]).

Patients and methods

Japanese physicians specializing in psychiatry or psychosomatic medicine in the medical database of Nihon Ultmarc Inc. (Chuo-Ku, Tokyo, Japan), who had treated ≥30 patients with MDD in the past month were invited to complete a web-based questionnaire from January 15 to 29, 2018. The questionnaire was comprised of 28 questions pertaining to the physician’s background, the criteria and tools used to diagnose MDD during physician–patient consultation, and actual and preferred duration of physician–patient consultation. Responses were given as single answer numerical values or as multiple-choice answers.

Results

From the 518 physicians invited to participate, 340 completed questionnaires were analyzed. Respondents were predominantly male (90%), hospital based (73%), affiliated with the Department of Psychiatry (95%), and members of the Japanese Society of Psychiatry and Neurology (87%). The majority of physicians (84%) agreed that “improvement of cognitive dysfunction caused by major depression is an important factor for patients to return to work” was the most challenging aspect of MDD diagnosis and management. Moreover, 83% of physicians conducted psychological assessments using a cognition evaluation test with most of their patients at the time of MDD diagnosis; the most commonly used tool was the Hasegawa Dementia Scale-Revised. Both hospital-based physicians and general practitioners would prefer to have longer consultations with their patients.

Conclusion

Physicians acknowledge the importance of the assessment and management of cognitive dysfunction in patients with MDD. However, most physicians would prefer to have longer consultation times with their patients for the diagnosis of MDD. In the future, it may be useful to introduce digital tools (eg, THINC-it^®) for the initial screening of cognitive dysfunction.

Keywords:

• Japan
• survey
• diagnosis
• management
• major depression disorder

Acknowledgments

The authors would like to thank the physicians who participated in this survey. They would like to thank Ms Manami Yoshida and Dr Shinzo Hiroi of Takeda Pharmaceutical Co. Ltd. (Tokyo, Japan) for their contribution in planning the study and development of the questionnaire, and acknowledge Mr Kohei Mizui and Mr Tomoyuki Kusaka of Social Survey Research Information Co. Ltd. (Tokyo, Japan) for their support in delivering the survey and statistical analysis. Medical writing support was provided by Mai Kurihara of Firekite, an Ashfield company, part of UDG Healthcare plc (Dublin, Ireland), which was funded by Takeda Pharmaceutical Co. Ltd., and complied with Good Publication Practice 3 ethical guidelines. This study was funded by Takeda Pharmaceutical Co. Ltd.

Ethics approval and informed consent

All participants consented to the personal information protection law and their guidelines. All responses were anonymized and ethics approval was not required.

Abbreviations

DSST, Digit Symbol Substitution Test; ECG, electrocardiogram; EEG, electroencephalogram; HAM-D, Hamilton Depression Rating Scale; HDS-R, Hasegawa Dementia Scale-Revised; MADRS, Montgomery–Åsberg Depression Rating Scale; MDD, major depressive disorder; MMSE, Mini-Mental State Examination; PDQ-D, Perceived Deficits Questionnaire-Depression; QIDS-J, Quick Inventory of Depressive Symptomatology-Japan; SDS, Zung Self-Rating Depression Scale; YMRS, Young Mania Rating Scale.

Data sharing statement

Takeda makes patient-level, de-identified data sets and associated documents available after applicable marketing approvals and commercial availability have been received, an opportunity for the primary publication of the research has been allowed, and other criteria have been met as set forth in Takeda’s Data Sharing Policy (see https://www.takedaclinicaltrials.com for details). To obtain access, researchers must submit a legitimate academic research proposal for adjudication by an independent review panel, who will review the scientific merit of the research and the requestor’s qualifications and conflict of interest that can result in potential bias. Once approved, qualified researchers who sign a data sharing agreement are provided access to these data in a secure research environment.

Disclosure

HH has received speaker’s honoraria from Otsuka Pharmaceutical, Eli Lilly, Pfizer, Takeda Pharmaceutical Co. Ltd., Dainippon-Sumitomo Pharma, Meiji-Seika Pharma, Merck Sharp & Dohme Pharma, and Janssen Pharmaceutical in the past 3 years. KY is an employee of Takeda Pharmaceutical Co. Ltd. The authors report no other conflicts of interest in this work.