Antidepressant and antipsychotic treatment of Psychotic Major Depression in a British mental healthcare setting

Figures & data

Table 1. Demographic characteristics, prevalence of clinical symptoms and length of stay.

Demographic variable	Descriptive statistics N (%)
Sex
Female	1730 (61.0%)
Male	1107 (39.0%)
Ethnicity
White	1401 (49.4%)
Black	850 (30.0%)
Asian	223 (7.9%)
Other	302 (10.7%)
	Mean (SD)
Age	46.4 (16.4)
Deprivation	24.5 (15.0)
Clinical symptoms	N (%)
Low mood	2485 (87.6%)
Irritability	1106 (39.0%)
Disturbed sleep	2176 (76.7%)
Energy	1236 (43.6%)
Appetite	1567 (55.2%)
Poor motivation	1473 (51.9%)
Attempted suicide	1049 (37.0%)
Delusions	1460 (51.5%)
Hallucinations	848 (29.9%)
Overall severity	Mean (SD)
Number of inpatient days	17.4 (43.6)

N (%): number of individuals and percentage of sample; SD: standard deviation.

Table 2. Use of pharmacological treatments.

Medication	Total N (%)
Antidepressant only	310 (10.9%)
Antipsychotic only	292 (10.3%)
Combination of an antidepressant and antipsychotic	1982 (69.9%)
No antidepressant or antipsychotic treatment	253 (8.9%)

N (%): number of individuals and percentage of sample that received each type of pharmacological treatment.

Table 3. Multivariable regression analyses of clinical characteristics associated with antidepressant and antipsychotic use in patients with PMD.

Clinical characteristics	Unadjusted odds ratios				Adjusted odds ratios
	Multinomial logistic regression				Multinomial logistic regression
	AD	AP OR (95% CI)	Combination OR (95% CI)	None OR (95% CI)	AD	AP aOR (95% CI)	Combination aOR (95% CI)	None aOR (95% CI)
Low mood	R E F E R E N C E C A T E G O R Y	.63	1.71**	.12***	R E F E R E N C E C A T E G O R Y	.57*	.83	.28***
		(.40–1.01)	(1.16–2.54)	(.08–.18)		(.33–.97)	(.53–1.28)	(.17–.46)
Irritability		1.81***	1.60***	.21***		1.90**	.99	.50*
		(1.30–2.52)	(1.24–2.06)	(.13–.35)		(1.32–2.82)	(.74–1.31)	(.29–.86)
Disturbed sleep		.74	1.98***	.19***		.63*	1.22	.51**
		(.52–1.04)	(1.50–2.62)	(.14–.28)		(.41–.97)	(.88–1.69)	(.33–.80)
Energy		.55**	1.45**	.23***		.60**	1.02	.63
		(.39–.78)	(1.13–1.84)	(.15–.35)		(.40–.88)	(.77–1.34)	(.39–1.02)
Appetite		.70*	1.71***	.24***		.74	1.23	.63*
		(.50–.96)	(1.35–2.18)	(.16–.35)		(.51–1.08)	(.94–1.62)	(.40–.98)
Poor motivation		.72	1.81***	.22***		.79	1.35*	.59*
		(.52–1.00)	(1.42–2.30)	(.15–.33)		(.55–1.15)	(1.03–1.77)	(.37–.93)
Attempted suicide		.66*	1.18	.40***		.61*	.75*	1.21
		(.46–.93)	(.92–1.51)	(.27–.59)		(.41–.89)	(.57–.99)	(.77–1.92)
Delusions		3.08***	3.38***	.56**		4.01***	2.76***	1.37
		(2.20–4.32)	(2.60–4.38)	(.38–.84)		(2.75–5.85)	(2.09–3.66)	(.88–2.15)
Hallucinations		1.16	1.79***	.34***		1.07	1.34	.68
		(.80–1.69)	(1.35–2.38)	(.21–.57)		(.72–1.59)	(1.00–1.81)	(.40–1.17)
Inpatient days		1.008*	1.014***	.95***		1.006	1.008**	.99
		(1.00–1.01)	(1.01–1.02)	(.92–.97)		(.99–1.01)	(1.003–1.01)	(.97–1.01)

‘AD’: antidepressant monotherapy; ‘AP’: antipsychotic monotherapy; ‘Combination’: antidepressant and antipsychotic combination treatment; ‘None’: no use of antidepressants or antipsychotics; ‘OR’: odds ratio; ‘95% CI’: 95% confidence intervals; aOR: odds ratio adjusted for demographic variables (age, sex, deprivation, ethnicity) and all other clinical characteristics. *p < .05, **p < .01, ***p < .001.

Data availability statement

The data used in this paper was from the South London and Maudsley (SLaM) Biomedical Research Centre (BRC) case register. Due to privacy protection of health-related data, access is only possible within the BRC premises.