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Trajectories of change in depression severity during treatment with antidepressants
- Source :
- Uher, R, Muthén, B, Souery, D, Mors, O, Jaracz, J, Placentino, A, Petrovic, A, Zobel, A, Henigsberg, N, Rietschel, M, Aitchison, K J, Farmer, A & McGuffin, P 2009, ' Trajectories of change in depression severity during treatment with antidepressants ', Psychological Medicine, pp. 1-11 . https://doi.org/10.1017/S0033291709991528
- Publication Year :
- 2010
-
Abstract
- BackgroundResponse and remission defined by cut-off values on the last observed depression severity score are commonly used as outcome criteria in clinical trials, but ignore the time course of symptomatic change and may lead to inefficient analyses. We explore alternative categorization of outcome by naturally occurring trajectories of symptom change.MethodGrowth mixture models were applied to repeated measurements of depression severity in 807 participants with major depression treated for 12 weeks with escitalopram or nortriptyline in the part-randomized Genome-based Therapeutic Drugs for Depression study. Latent trajectory classes were validated as outcomes in drug efficacy comparison and pharmacogenetic analyses.ResultsThe final two-piece growth mixture model categorized participants into a majority (75%) following a gradual improvement trajectory and the remainder following a trajectory with rapid initial improvement. The rapid improvement trajectory was over-represented among nortriptyline-treated participants and showed an antidepressant-specific pattern of pharmacogenetic associations. In contrast, conventional response and remission favoured escitalopram and produced chance results in pharmacogenetic analyses. Controlling for drop-out reduced drug differences on response and remission but did not affect latent trajectory results.ConclusionsLatent trajectory mixture models capture heterogeneity in the development of clinical response after the initiation of antidepressants and provide an outcome that is distinct from traditional endpoint measures. It differentiates between antidepressants with different modes of action and is robust against bias due to differential discontinuation.
- Subjects :
- Adult
Male
medicine.medical_specialty
Genotype
Personality Inventory
Psychometrics
Nortriptyline
Citalopram
law.invention
Efficacy
Randomized controlled trial
Recurrence
law
Internal medicine
medicine
Humans
Escitalopram
Psychiatry
Applied Psychology
Depression (differential diagnoses)
Depressive Disorder
Reproducibility of Results
Middle Aged
Weights and Measures
Antidepressive Agents
Receptors, Adrenergic
Discontinuation
Europe
Clinical trial
Psychiatry and Mental health
Pharmacogenetics
Receptors, Serotonin
Female
Psychology
antidepressant response
depression
growth mixture modelling
randomized controlled trials
Follow-Up Studies
medicine.drug
Subjects
Details
- Language :
- English
- ISSN :
- 00332917
- Database :
- OpenAIRE
- Journal :
- Uher, R, Muthén, B, Souery, D, Mors, O, Jaracz, J, Placentino, A, Petrovic, A, Zobel, A, Henigsberg, N, Rietschel, M, Aitchison, K J, Farmer, A & McGuffin, P 2009, ' Trajectories of change in depression severity during treatment with antidepressants ', Psychological Medicine, pp. 1-11 . https://doi.org/10.1017/S0033291709991528
- Accession number :
- edsair.doi.dedup.....35f97c0c3fb9055bf5fb3bded00034a0
- Full Text :
- https://doi.org/10.1017/s0033291709991528