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

Autor: Kautzky A; Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria., Dold M; Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria., Bartova L; Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria., Spies M; Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria., Kranz GS; Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria.; Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong., Souery D; Universit_e Libre de Bruxelles and Psy Pluriel Centre Europ_een de Psychologie Medicale, Brussels, Belgium., Montgomery S; Imperial College, University of London, London, UK., Mendlewicz J; School of Medicine, Free University of Brussels, Brussels, Belgium., Zohar J; Psychiatric Division, Chaim Sheba Medical Center, Ramat Gan, Israel., Fabbri C; Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy., Serretti A; Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy., Lanzenberger R; Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria., Dikeos D; Department of Psychiatry, Athens University Medical School, Athens, Greece., Rujescu D; University Clinic for Psychiatry, Psychotherapy and Psychosomatic, Martin-Luther-University Halle-Wittenberg, Halle, Germany., Kasper S; Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria.
Jazyk: angličtina
Zdroj: Acta psychiatrica Scandinavica [Acta Psychiatr Scand] 2019 Jan; Vol. 139 (1), pp. 78-88. Date of Electronic Publication: 2018 Oct 05.
DOI: 10.1111/acps.12959
Abstrakt: Objectives: Clinical variables were investigated in the 'treatment resistant depression (TRD)- III' sample to replicate earlier findings by the European research consortium 'Group for the Study of Resistant Depression' (GSRD) and enable cross-sample prediction of treatment outcome in TRD.
Experimental Procedures: TRD was defined by a Montgomery and Åsberg Depression Rating Scale (MADRS) score ≥22 after at least two antidepressive trials. Response was defined by a decline in MADRS score by ≥50% and below a threshold of 22. Logistic regression was applied to replicate predictors for TRD among 16 clinical variables in 916 patients. Elastic net regression was applied for prediction of treatment outcome.
Results: Symptom severity (odds ratio (OR) = 3.31), psychotic symptoms (OR = 2.52), suicidal risk (OR = 1.74), generalized anxiety disorder (OR = 1.68), inpatient status (OR = 1.65), higher number of antidepressants administered previously (OR = 1.23), and lifetime depressive episodes (OR = 1.15) as well as longer duration of the current episode (OR = 1.022) increased the risk of TRD. Prediction of TRD reached an accuracy of 0.86 in the independent validation set, TRD-I.
Conclusion: Symptom severity, suicidal risk, higher number of lifetime depressive episodes, and comorbid anxiety disorder were replicated as the most prominent risk factors for TRD. Significant predictors in TRD-III enabled robust prediction of treatment outcome in TRD-I.
(© 2018 The Authors Acta Psychiatrica Scandinavica Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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