Predictors of response and remission in a naturalistic inpatient sample undergoing multimodal treatment for depression
Beteiligte Einrichtungen
Abstract
BACKGROUND: Many depressed patients do not achieve response or remission despite adequate treatment. Identifying predictors of outcome can contribute to developing therapeutic algorithms for difficult-to-treat depression. Therefore, we examined clinical predictors of response and remission in a naturalistic inpatient sample undergoing multimodal treatment for depression.
METHODS: Three hundred and fifty-one consecutive inpatients admitted to a tertiary care university hospital (specialized psychiatry unit for treatment of unipolar and bipolar depression) between January 2014 and December 2016 were characterized by a set of sociodemographic and clinical variables. The predictive value of these variables for response (≥ 50% decrease from baseline Montgomery-Åsberg Depression Rating Scale (MADRS) score) and remission (MADRS score at discharge < 10) were explored using bivariate analysis and logistic regression.
RESULTS: Greater symptom severity and fewer psychotropic medications at the time of admission predicted response. Remission rates were higher for patients with non-chronic depression, higher number of previous depressive episodes, fewer psychotropic medications and less severe depression at admission.
LIMITATIONS: This was a retrospective study without a control group. The sample was drawn from a single inpatient ward specialized for difficult-to-treat depression.
CONCLUSIONS: Greater baseline depression severity might be a proxy for a less chronic course of depression thereby explaining its association with greater response rates. Fewer episodes in the past and polypharmacy could indicate treatment-resistance and chronicity, contributing to lower remission rates. Therefore, preventing chronicity should be a central aim of depression treatment.
Bibliografische Daten
Originalsprache | Englisch |
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ISSN | 0165-0327 |
DOIs | |
Status | Veröffentlicht - 01.06.2019 |
Anmerkungen des Dekanats
Copyright © 2019. Published by Elsevier B.V.
PubMed | 30981062 |
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