Suicide characteristics in patients with marked treatment-resistant major depressive disorder: A RECOVER trial report.

Autor: de Leon VC; Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA. Electronic address: deleonv@wustl.edu., Allen RM; Seattle Neuropsychiatric Treatment Center, Seattle, WA, USA., Quevedo J; Center for Interventional Psychiatry, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA., Riva-Posse P; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA., Aaronson ST; Institute for Advanced Diagnostics and Therapeutics, Sheppard Pratt Health System, Baltimore, MD, USA., Berger MA; Offices of Psychiatry and Counseling Services, Moosic, PA, USA., Zajecka J; Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA; Psychiatric Medicine Associates, LLC, Skokie, IL, USA., Banov MD; Department of Psychiatry, Medical College of Georgia, Augusta, GA, USA; PsychAtlanta Research Center, Marietta, GA, USA., Manu LM; Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA., Sheline YI; University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA., Farrington J; Mulva Clinic for the Neurosciences, Dell Medical School, The University of Texas at Austin, Austin, TX, USA., Eloge JC; Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA., Beard J; LivaNova PLC (or a subsidiary), London, United Kingdom., Kriedt CL; Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA., Gott BM; Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA., Brown H; Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA., Bunker MT; LivaNova PLC (or a subsidiary), London, United Kingdom., Lee YL; LivaNova PLC (or a subsidiary), London, United Kingdom., Rush AJ; Duke-NUS Medical School, Singapore; Curbstone Consultant LLC, Dallas, TX, USA., Sackeim HA; Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA., Conway CR; Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA.
Jazyk: angličtina
Zdroj: Journal of affective disorders [J Affect Disord] 2024 Dec 23. Date of Electronic Publication: 2024 Dec 23.
DOI: 10.1016/j.jad.2024.12.072
Abstrakt: Background: Suicide attempts are a major concern in major depressive disorder (MDD), especially for those with multiple prior unsuccessful treatment trials. This report compares baseline demographic, clinical features, and treatment history of participants with marked treatment-resistant, nonpsychotic MDD based on lifetime history of suicide attempt (SA vs NSA).
Methods: RECOVER is a randomized, sham-controlled trial of vagus nerve stimulation and the largest such trial of a psychiatric neuromodulation intervention. Baseline data were analyzed. Univariate analyses (SA vs NSA) and logistic regression with backward selection (variables with univariate p < 0.1) were performed.
Results: SA group (N = 196) was more likely than NSA group (N = 297) to be female (72.4 % vs 61.6 %), <65 years of age (73.5 % vs 61.6 %), have earlier onset of depressive symptoms (mean, 19.1 vs 22.5 years), earlier diagnosis of MDD (mean, 25.0 vs 29.2 years), higher percentage of lifetime in depressive episodes (mean, 56.0 % vs 51.0 %), more failed antidepressants (mean, 15.0 vs 12.1), and greater lifetime use of electroconvulsive therapy (ECT; 55.1 % vs 40.1 %). Female sex, age at MDD diagnosis, number of failed antidepressants, number of psychiatric hospitalizations, and baseline suicide score retained association with logistic regression analysis.
Limitations: Information on medical morbidity of suicide attempts was not collected and timing of suicide attempts relative to treatment exposures was unknown.
Conclusions: For marked treatment-resistant MDD, those with prior suicide attempts have more complex course of illness with earlier onset of depressive symptoms, earlier diagnosis of MDD, more lifetime spent in depressive illness, more failed antidepressant medication trials, and greater use of ECT.
Trial Registration: ClinicalTrials.gov Identifier NCT03887715.
Competing Interests: Declaration of competing interest MAB, YIS, JCE, CLK, BMG, and HB have no conflicts of interest to declare. VDL receives funding from the Washington University Institute of Clinical and Translational Sciences, UL1 TR002345, and sub-award TL1 TR002344. RMA is one of the owners of a multi-site interventional psychiatry and clinical trials company, Seattle Neuropsychiatric Treatment Center; receives research funding from LivaNova and Compass Pathways; and previously received research funding from Alto Neuroscience. JQ has received clinical research support from LivaNova; has speaker bureau membership with Myriad Neuroscience and AbbVie; consultant for Eurofarma; stockholder at Instituto de Neurociencias; and receives copyrights from Artmed Editora, Artmed Panamericana, and Elsevier/Academic Press. PRP is a consultant for LivaNova, Janssen Pharmaceuticals, MotifNeuro, and Abbott Neuromodulation. STA is a consultant to Genomind, LivaNova, Janssen, Neuronetics, and Sage Therapeutics; and has received research support from Compass Pathways and Neuronetics. JZ has received research support from Boehringer-Ingelheim, Compass Pathways, Hoffman-LaRoche, Johnson and Johnson (Janssen), LivaNova, Otsuka, Neurocrine Bioscience, and Sage Therapeutics; and received consulting fees from Alphasigma USA, Johnson and Johnson (Janssen), and Novartis Pharmaceuticals. MDB is a consultant for LivaNova and received speaker's honoraria from Intracellular, Janssen, Teva, Axsome, Abbvie, and Supernus. LMM is a consultant to and speaker for Janssen Pharmaceuticals; and has received research support from Janssen Pharmaceuticals and LivaNova. JF has conducted clinical studies sponsored by Navidea Biopharmaceuticals, Compass Pathways, Jazz Pharmaceuticals, LivaNova PLC, Boehringer Ingelheim, Sage Therapeutics, Relmada Therapeutics, and Reunion Neuroscience; provided expert testimony for Thornton, Biechlin, Reynolds and Guerra Law Firm; and received grants from CPRIT, NIH, and NIMH. JB and Y-CL are employees of LivaNova. MTB is a former employee and a current consultant of LivaNova. AJR has received consulting fees from Compass, Curbstone Consultant, Emmes, Evecxia Therapeutics, Holmusk Technologies, ICON, Johnson and Johnson (Janssen), LivaNova, MindStreet, Neurocrine Biosciences, Otsuka-US; speaking fees from LivaNova, Johnson and Johnson (Janssen), and Wolters Kluwer Health; royalties from Guilford Press and UT Southwestern Medical Center (for the Inventory of Depressive Symptoms and its derivatives); named co-inventor on US Patent 7,795,033 (Methods to Predict the Outcome of Treatment with Antidepressant Medication, Inventors: McMahon FJ, Laje G, Manji H, Rush AJ, Paddock S, Wilson AS) and US Patent 7,906,283 (Methods to Identify Patients at Risk of Developing Adverse Events During Treatment with Antidepressant Medication, Inventors: McMahon FJ, Laje G, Manji H, Rush AJ, Paddock S). HAS serves as a scientific adviser and receives consulting fees from Cerebral Insights, Cerebral Therapeutics, Holmusk Technologies, LivaNova, MECTA Corporation, Neurolief, Neuronetics, Parow Entheobiosciences, and SigmaStim; receives honoraria and royalties from Elsevier and Oxford University Press; is the inventor of non-remunerative US patents for Focal Electrically Administered Seizure Therapy (FEAST), titration in the current domain in ECT, and the adjustment of current in ECT devices, each held by the SigmaStim Corporation; and is also the originator of magnetic seizure therapy (MST). CRC has received research support from the American Foundation for Suicide Prevention, Assurex Health, August Busch IV Foundation, Barnes-Jewish Hospital Foundation, LivaNova, National Institute of Mental Health, and the Taylor Family Institute for Innovative Psychiatric Research; consulted for LivaNova and Sage Therapeutics; and was a part-time employee at the John Cochran VA Medical Center in St. Louis.
(Copyright © 2024. Published by Elsevier B.V.)
Databáze: MEDLINE
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