Alignment between physician and patient perceptions of antidepressant treatment outcomes in routine clinical practice

Patient-reported perspectives have become increasingly relevant in the evaluation of psychiatric treatments. In depression, discrepancies between clinician assessments and patients' subjective experiences may arise, particularly in domains related to tolerability and daily functioning. Pragmatic investigations conducted under routine clinical practice conditions may help clarify how treatment outcomes are evaluated by different stakeholders. This observational, cross-sectional, multicentre study conducted in routine clinical practice compared physicians' and patients' opinions on antidepressant treatment outcomes following real-world use of tianeptine. Data were collected using structured self-administered questionnaires with 5-point Likert-type ordinal scales. Paired comparisons were performed using appropriate non-parametric tests. Sixty physicians and 542 patients from multiple clinical settings across Spain participated. Physicians' and patients' evaluations were largely concordant across global domains, with high or full satisfaction reported by 62% of physicians and 55% of patients, alongside similarly positive evaluations of quality of life impact. However, systematic differences were observed in tolerability-related domains. For example, null or low interference with daily life activities was reported by 68% of patients compared with 56% of physicians. The findings indicate a high degree of physician-patient concordance in global evaluations of antidepressant treatment outcomes under routine clinical conditions, alongside domain-specific differences in tolerability assessments. These findings highlight the importance of incorporating patient-reported perspectives when evaluating treatment experience in depression.