Factors associated with antipsychotic use in non-psychotic depressed patients: results from a clinical multicenter survey

BACKGROUND: The combination of antipsychotics is not well studied among non-psychotic major depressive disorder (MDD). This study aims to explore the antipsychotics use in this population and its associated factors. METHODS: This cross-sectional and multi-site study was conducted in 11 sites of China. one Thousand five hundred three eligible MDD patients after 8–12 weeks of antidepressant treatment were included consecutively. A structured questionnaire was used to obtain socio-demographic data and medical histories. The Chinese version of the Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR), the Patient Health Questionnaire-15 (PHQ-15) and the Sheehan Disability Scale (SDS) were used for patient self-rating. Logistic regression model was used to explore the associated factors that could potentially be influential for the use antipsychotic augmentation. RESULTS: Overall, quetiapine (43.4%) was the most commonly used as an adjunct to antidepressants, followed by olanzapine (38.8%). And antipsychotics were commonly combined with escitalopram (23.1%), venlafaxine (21.7%), sertraline (14.8%). The factors influencing the combination of antipsychotics in non-psychotic depressed patients included service setting (OR = 0.444; p < 0.001; 95%CI = 0.338–0.583), comorbidity of physical illness (OR = 1.704; p < 0.001; 95%CI = 1.274–2.278), PHQ level (OR = 0.680; p < 0.001; 95%CI = 0.548–0.844), SDS level (OR = 1.627; p < 0.001; 95%CI = 1.371–1.930) and antidepressants co-treatment (OR = 2.606; p < 0.001; 95%CI = 1.949–3.485). CONCLUSIONS: Antipsychotics use is common among non-psychotic MDD patient. Service setting, comorbidity of physical illness, somatic symptoms, social functioning and engagement, and antidepressants co-treatment could be the factors associated with the antipsychotics use in MDD patients.