Subgrouping time-dependent prescribing patterns of first-onset major depressive episodes by psychotropics dissection

Table 1 Univariate comparisons of demographic and clinical features by empirically-derived clusters (n = 105), mean ± SD

	Total	Simple pharmacy,short-term antidepressants use (SA, n = 19)	Simple pharmacy,long-term antidepressants use (LA, n = 33)	Complex pharmacy,long-term antidepressants and sedatives use (LAS, n = 34)	Complex pharmacy,long-term antidepressants, sedatives and augmentation use (LASA, n = 19)	P value for univariate omnibus test
Demographic and general clinical data
Age (yr)	51.5 (13.2)	42.6 (14.4)	50.6 (15.2)	54.9 (9.1)	56.5 (10.3)	0.02
Age of onset (yr)	44.5 (13.6)	36.3 (14.4)	43.2 (15.3)	48.6 (10.0)	49.6 (11.0)	0.01
Female, n (%)	80 (75.5)	15 (78.9)	24 (72.7)	27 (79.4)	13 (68.4)	0.79
Comorbid anxiety disorder, n (%)	22 (20.8)	6 (31.6)	9 (27.3)	4 (11.8)	3 (15.8)	0.25
Number of comorbid physical diseases	0.7 (1.3)	0.5 (1.2)	0.7 (1.4)	1.1 (1.5)	0.6 (1.2)	0.39
Follow-up duration after 2-yr of disease onset (yr)	3.7 (3.5)	3.2 (3.2)	3.4 (3.1)	3.7 (3.2)	3.8 (3.9)	0.91
Psychotropic loads
Antidepressant load (defined daily dose/month)	34.5 (18.4)	13.3 (7.2)	32.1 (13.1)	42.8 (17.3)	44.8 (17.7)	< 0.001
Sedative load (equivalent dose/month)	57.3 (56.8)	8.1 (10.8)	18.5 (20.9)	91.9 (45.4)	112.0 (56.7)	< 0.001
Augmentation load (defined daily dose/month)	1.2 (2.7)	0.1 (0.5)	0.3 (0.6)	0.3 (1.0)	5.3 (4.0)	< 0.001
Clinical feature within 2-yr of disease onset
Number of antidepressants use	1.7 (0.9)	1.3 (0.6)	1.6 (0.8)	1.9 (1.1)	1.9 (0.9)	0.07
Number of antidepressants use with adequate dosage and duration	1.5 (0.9)	1.1 (0.5)	1.3 (0.8)	1.7 (1.2)	1.8 (0.8)	0.04
Visits of psychiatric outpatient service	17.3 (10.7)	10.6 (5.8)	15.5 (5.1)	20.2 (10.6)	21.8 (17.1)	0.002
Frequencies of psychiatric admission	0.2 (0.5)	0.1 (0.3)	0.2 (0.4)	0.1 (0.3)	0.7 (0.8)	< 0.001
Clinical feature beyond 2-yr of disease onset
Visits of psychiatric outpatient service	31.1 (66.7)	9.7 (10.3)	20.2 (24.7)	41.4 (91.6)	42.6 (78.4)	0.22
Frequencies of psychiatric admission	0.8 (0.5)	0.0 (0.0)	0.1 (0.4)	0.1 (0.7)	0.0 (0.0)	0.71
Severity of depression in the recruitment1	1.5 (0.9)	0.6 (1.0)	0.9 (1.2)	1.2 (1.3)	1.7 (1.2)	0.02

¹Severity of depression was scored according to the level of depression, which was evaluated by the Beck Depression Inventory.

Table 2 Multivariable analyses for the comparisons of clinical features by empirically-derived clusters (n = 105)

	Simple pharmacy, short-term antidepressants use (SA, n = 19)	Simple pharmacy, long-term antidepressants use (LA, n = 33)	Complex pharmacy, long-term antidepressants and sedatives use (LAS, n = 34)	Complex pharmacy, long-term antidepressants, sedatives and augmentation use (LASA, n = 19)	P value for pos-hoc comparison using multivariable regression test
	IRR (95%CI)	IRR (95%CI)	IRR (95%CI)	IRR (95%CI)
Clinical feature within 2-yr of disease onset1
Number of antidepressants use	0.57 (0.32-0.82)	0.74 (0.52-0.97)	0.94 (0.66-1.23)	0.96 (0.61-1.31)
Number of antidepressants use with adequate dosage and duration	0.50 (0.26-0.73)	0.64 (0.44-0.85)	0.87 (0.59-1.15)	0.95 (0.60-1.31)	SA < LAS (P = 0.04); SA < LASA (P = 0.03)
Visits of psychiatric outpatient service	4.76 (4.04-5.47)	7.46 (6.75-8.17)	10.34 (9.37-11.30)	11.37 (10.15-12.58)	SA < LA (P < 0.001); SA < LAS (P < 0.001); SA < LASA (P < 0.001); LA < LAS (P < 0.001); LA < LASA (P < 0.001)
Frequencies of psychiatric admission	0.03 (-0.02-0.08)	0.05 (-0.002-0.10)	0.03 (-0.01-0.08)	0.24 (0.04-0.44)	SA < LASA (P = 0.01); LA < LASA (P = 0.004); LAS < LASA (P = 0.001)
Clinical feature beyond 2-yr of disease onset
Visits of psychiatric outpatient service2	3.03 (2.58-3.49)	5.81 (5.34-6.30)	10.21 (9.49-10.93)	10.86 (9.98-11.74)	SA < LAS (P < 0.001); SA < LA (P < 0.001); SA < LASA (P < 0.001); LA < LAS (P < 0.001); LA < LASA (P < 0.001)
Frequencies of psychiatric admission3	-	-	-	-
	EMM (95%CI)	EMM (95%CI)	EMM (95%CI)	EMM (95%CI)
Severity of depression in the recruitment4	0.58 (0.23-0.93)	0.90 (0.54-1.25)	1.66 (1.10-2.22)	2.20 (1.37-3.30)	SA < LAS (P = 0.002); SA < LASA (P < 0.001); LA < LAS (P = 0.02); LA < LASA (P = 0.001)

¹Covariates included into the Poisson regression model were sex, age of onset, comorbid anxiety disorder, and number of medical comorbidities. OFFSET = logarithm (2).

²Covariates included into the multivariable Poisson regression model were sex, age of onset, comorbid anxiety disorder, and number of medical comorbidities. OFFSET = logarithm (duration of course beyond 2-yr of disease onset).

³Covariates included into the multivariable Poisson regression model were sex, age of onset, comorbid anxiety disorder, and number of medical comorbidities. OFFSET = logarithm (duration of course beyond 2-yr of disease onset). This model failed to converge because of zero count in some clusters.

⁴Covariates included into the general linear model were sex, age of onset, comorbid anxiety disorder, number of medical comorbidities, and duration of course beyond 2-yr of disease onset. Severity of depression was scored according to the level of depression, which was evaluated by the Beck Depression Inventory. IRR: Incident rate ratio; EMM: Estimated marginal mean.

CI: Confidence interval.