Clinical factors predicting treatment resistant depression: affirmative results from the European multicenter study

Kautzky, Alexander; Dold, Markus; Bartova, Lucie; Spies, Marie; Kranz, Georg; Souery, Daniel; Montgomery, Stuart; Mendlewicz, Julien; Zohar, Joseph; Fabbri, Chiara; Serretti, Alessandro; Lanzenberger, Rupert; Dikeos, Dimitris; Rujescu, Dan; Kasper, Siegfried

doi:10.1111/acps.12959

Cited by 108 publications

(97 citation statements)

References 39 publications

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“…According to modern studies, depressive disorders are characterized by polymorphism of symptoms, difficulty of diagnosis and resistance to therapy [4][5][6][7]. In this regard, it is important to study the clinical phenomenology of depressive disorders at the present stage, which can be the basis for the development of effective preventive measures [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Age and Gender Features of Depressive and Anxiety Symptomatics of Depressive Disorders

Белов

Пшук

2020

Wiad Lek

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The aim: of the study is to study the features of the clinical phenomenology of depressive disorders at the present stage, taking into account gender and age factors. Materials and methods: Clinically examined 107 men and 138 women with bipolar affective disorder (current episode of depression), depressive episode and recurrent depressive disorder using HDRS, HARS, BDI, C. Spilberger’s Scale of Reactive and Personality Anxiety. Results: In all patients showed an increase in the severity of depression and anxiety with age, but in women the greatest differences were found between the middle and older age groups, and in men when comparing young and middle age groups. In young patients the level of agitated depression is higher for men, and women showed the higher overall level of anxiety, somatic anxiety, undifferentiated depression, reactive and personality anxiety. In patients aged 30-44, men have a significantly higher overall score of HARS depression, the level of adynamic, agitated and undifferentiated depression, the level of depression on BDI. In the older age group, the levels of depression in men and women are not significantly different, and the levels of mental anxiety and personality anxiety in women are significantly higher. Conclusions: The general tendency consisting in increasing the severity of depression with age, and more pronounced indicators of depression in men, and anxiety in women. In men, the greatest increase in the severity of depression occurs before the age of 44 years, and in women after 45 years.

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Section: Introductionmentioning

confidence: 99%

Age and Gender Features of Depressive and Anxiety Symptomatics of Depressive Disorders

Белов

Пшук

2020

Wiad Lek

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“…The term treatment-resistant depression (TRD) has been used increasingly over the last decades and usually translates into MDD in which the patient's condition has not responded to two or more adequate treatment trials (Conway, George, & Sackeim, 2017;Ruhe, van Rooijen, Spijker, Peeters, & Schene, 2012). Depending on whether response or remission of symptoms is used in the definition of TRD, the proportion among patients with MDD meeting these criteria ranged between 35% and 64% in the large clinical data sets from the Sequenced Treatment Alternatives to Relieve Depression (STAR Ã D) study and the European Group for the Study of Resistant Depression samples (Kautzky et al, 2019;Rush, Trivedi, Wisniewski, Nierenberg et al, 2006Souery et al, 2007). Despite this, studies with long-term follow-up of patients with TRD are scarce and do not include risk factor analyses of adverse outcomes such as death or suicide (Dunner et al, 2006;Fekadu et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Suicide and Suicide Attempts Among Patients With Treatment-Resistant Depression: Nested Case-Control Study

Reutfors

Andersson

Tanskanen

et al. 2019

Archives of Suicide Research

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The risk of suicide is elevated among patients with treatment-resistant depression (TRD). Risk factors for suicide and suicide attempts among cases and controls with TRD were investigated using data from nationwide Swedish registers. Among 119,407 antidepressant initiators with a diagnosis of depression, 15,631 patients who started a third sequential treatment trial during the same depressive episode were classified with TRD. A nested casecontrol study compared cases with suicide and suicide attempts with up to three closely matched controls. Sociodemographic and clinical risk factors were assessed using conditional logistic regression analyses. In all, 178 patients died by suicide and 1,242 experienced a suicide attempt during follow-up. History of suicide attempts, especially if <1 year after the attempt, was a significant independent risk factor for suicide (adjusted odds ratio [aOR], 8.9; 95% confidence interval [CI], 5.1-15.7) as were 10 to 12 years of education compared to lower education (aOR, 1.69; 95% CI, 1.02-2.81). For attempted suicide, the strongest independent risk factors were history of suicide attempts (<1 year aOR, 5.1; 95% CI, 4.0-6.5), substance abuse (aOR, 2.6; 95% CI, 2.2-3.1), personality disorders (aOR, 1.9; 95% CI, 1.5-2.3), and somatic comorbidity (aOR, 2.0; 95% CI, 1.04-3.9). Suicide attempts, especially if recent, are strong risk factors for completed suicide among patients with TRD. Established risk factors for suicide attempts were confirmed for patients with TRD.

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“…The concept of TRD has generated a substantial amount of study and collaboration that has attempted to characterize TRD. For example, in Europe, the European Group for the Study of Resistant Depression has published several studies and reviews Kautzky et al, 2019;Schosser et al, 2012;Souery et al, 2007) Our narrative review indicated that no consensus definition existed for TRD. We identified four basic definitions for TRD (three for MDD, one for bipolar disorder).…”

Section: Discussionmentioning

confidence: 93%

“…For example, in Europe, the European Group for the Study of Resistant Depression has published several studies and reviewsKautzky et al, 2019;Schosser et al, 2012;Souery et al, 2007) that have influenced current treatment recommendations of the European Medicines Agency (European Medicines Agency, 2013). We assessed how well this available literature addressed two main questions: what was the consensus definition for TRD, and how this definition applied in intervention trials.…”

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confidence: 99%

Defining treatment‐resistant depression

et al. 2019

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Background: Varying conceptualizations of treatment-resistant depression (TRD) have made translating research findings or systematic reviews into clinical practice guidelines challenging and inconsistent. Methods: We conducted a review for the Centers for Medicare & Medicaid Services and the Agency for Healthcare Research and Quality to clarify how experts and investigators have defined TRD and to review systematically how well this definition comports with TRD definitions in clinical trials through July 5, 2019. Results: We found that no consensus definition existed for TRD. The most common TRD definition for major depressive disorder required a minimum of two prior treatment failures and confirmation of prior adequate dose and duration. The most common TRD definition for bipolar disorder required one prior treatment failure. No clear consensus emerged on defining adequacy of either dose or duration. Our systematic review found that only 17% of intervention studies enrolled samples meeting the most frequently specified criteria for TRD. Depressive outcomes and clinical global impressions were commonly measured; functional impairment and quality-of-life tools were rarely used. Conclusions:Two key steps are critical to advancing TRD research: (a) Developing a consensus definition of TRD that addresses how best to specify the number of prior treatment failures and the adequacy of dose and duration; and (b) identifying a core package of outcome measures that can be applied in a standardized manner. Our recommendations about stronger approaches to designing and conducting TRD research will foster better evidence to translate into clearer guidelines for treating patients with this serious condition.

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Clinical factors predicting treatment resistant depression: affirmative results from the European multicenter study

Cited by 108 publications

References 39 publications

Age and Gender Features of Depressive and Anxiety Symptomatics of Depressive Disorders

Age and Gender Features of Depressive and Anxiety Symptomatics of Depressive Disorders

Risk Factors for Suicide and Suicide Attempts Among Patients With Treatment-Resistant Depression: Nested Case-Control Study

Defining treatment‐resistant depression

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