1. Clinical factors predicting treatment resistant depression: affirmative results from the European multicenter study.
- Author
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Kautzky A, Dold M, Bartova L, Spies M, Kranz GS, Souery D, Montgomery S, Mendlewicz J, Zohar J, Fabbri C, Serretti A, Lanzenberger R, Dikeos D, Rujescu D, and Kasper S
- Subjects
- Adult, Affective Disorders, Psychotic diagnosis, Affective Disorders, Psychotic psychology, Aged, Antidepressive Agents administration & dosage, Antidepressive Agents therapeutic use, Anxiety Disorders diagnosis, Anxiety Disorders psychology, Clinical Decision Rules, Cross-Sectional Studies, Depressive Disorder, Treatment-Resistant epidemiology, Episode of Care, Europe epidemiology, Female, Humans, Inpatients psychology, Inpatients statistics & numerical data, Male, Middle Aged, Psychiatric Status Rating Scales, Retrospective Studies, Risk, Severity of Illness Index, Suicidal Ideation, Treatment Outcome, Antidepressive Agents pharmacology, Depressive Disorder, Treatment-Resistant diagnosis, Depressive Disorder, Treatment-Resistant psychology
- Abstract
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.)
- Published
- 2019
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