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Is prior course of illness relevant to acute or longer-term outcomes in depressed out-patients? A STAR*D report.

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Title: Is prior course of illness relevant to acute or longer-term outcomes in depressed out-patients? A STAR*D report.
Authors: Rush, A. J., Wisniewski, S. R., Zisook, S., Fava, M., Sung, S. C., Haley, C. L., Chan, H. N., Gilmer, W. S., Warden, D., Nierenberg, A. A., Balasubramani, G. K., Gaynes, B. N., Trivedi, M. H., Hollon, S. D.
Source: Psychological Medicine. Jun2012, Vol. 42 Issue 6, p1131-1149. 19p.
Subjects: Antidepressants, Mental depression, Citalopram, Outpatient medical care, Analysis of variance, Chi-squared test, Longitudinal method, Classification of mental disorders, Health outcome assessment, Patients, Questionnaires, Research funding, Scales (Weighing instruments), Self-evaluation, Statistics, Survival analysis (Biometry), Disease relapse, Logistic regression analysis, Data analysis, Treatment effectiveness, Data analysis software, Kaplan-Meier estimator, Therapeutics
Abstract: BackgroundMajor depressive disorder (MDD) is commonly chronic and/or recurrent. We aimed to determine whether a chronic and/or recurrent course of MDD is associated with acute and longer-term MDD treatment outcomes.MethodThis cohort study recruited out-patients aged 18–75 years with non-psychotic MDD from 18 primary and 23 psychiatric care clinics across the USA. Participants were grouped as: chronic (index episode >2 years) and recurrent (n=398); chronic non-recurrent (n=257); non-chronic recurrent (n=1614); and non-chronic non-recurrent (n=387). Acute treatment was up to 14 weeks of citalopram (⩽60 mg/day) with up to 12 months of follow-up treatment. The primary outcomes for this report were remission [16-item Quick Inventory of Depressive Symptomatology – Self-Rated (QIDS-SR16) ⩽5] or response (⩾50% reduction from baseline in QIDS-SR16) and time to first relapse [first QIDS-SR16 by Interactive Voice Response (IVR) ⩾11].ResultsMost participants (85%) had a chronic and/or recurrent course; 15% had both. Chronic index episode was associated with greater sociodemographic disadvantage. Recurrent course was associated with earlier age of onset and greater family histories of depression and substance abuse. Remission rates were lowest and slowest for those with chronic index episodes. For participants in remission entering follow-up, relapse was most likely for the chronic and recurrent group, and least likely for the non-chronic, non-recurrent group. For participants not in remission when entering follow-up, prior course was unrelated to relapse.ConclusionsRecurrent MDD is the norm for out-patients, of whom 15% also have a chronic index episode. Chronic and recurrent course of MDD may be useful in predicting acute and long-term MDD treatment outcomes. [ABSTRACT FROM PUBLISHER]
Copyright of Psychological Medicine is the property of Cambridge University Press and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Is prior course of illness relevant to acute or longer-term outcomes in depressed out-patients? A STAR*D report.
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  Data: <searchLink fieldCode="AR" term="%22Rush%2C+A%2E+J%2E%22">Rush, A. J.</searchLink><br /><searchLink fieldCode="AR" term="%22Wisniewski%2C+S%2E+R%2E%22">Wisniewski, S. R.</searchLink><br /><searchLink fieldCode="AR" term="%22Zisook%2C+S%2E%22">Zisook, S.</searchLink><br /><searchLink fieldCode="AR" term="%22Fava%2C+M%2E%22">Fava, M.</searchLink><br /><searchLink fieldCode="AR" term="%22Sung%2C+S%2E+C%2E%22">Sung, S. C.</searchLink><br /><searchLink fieldCode="AR" term="%22Haley%2C+C%2E+L%2E%22">Haley, C. L.</searchLink><br /><searchLink fieldCode="AR" term="%22Chan%2C+H%2E+N%2E%22">Chan, H. N.</searchLink><br /><searchLink fieldCode="AR" term="%22Gilmer%2C+W%2E+S%2E%22">Gilmer, W. S.</searchLink><br /><searchLink fieldCode="AR" term="%22Warden%2C+D%2E%22">Warden, D.</searchLink><br /><searchLink fieldCode="AR" term="%22Nierenberg%2C+A%2E+A%2E%22">Nierenberg, A. A.</searchLink><br /><searchLink fieldCode="AR" term="%22Balasubramani%2C+G%2E+K%2E%22">Balasubramani, G. K.</searchLink><br /><searchLink fieldCode="AR" term="%22Gaynes%2C+B%2E+N%2E%22">Gaynes, B. N.</searchLink><br /><searchLink fieldCode="AR" term="%22Trivedi%2C+M%2E+H%2E%22">Trivedi, M. H.</searchLink><br /><searchLink fieldCode="AR" term="%22Hollon%2C+S%2E+D%2E%22">Hollon, S. D.</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22Psychological+Medicine%22">Psychological Medicine</searchLink>. Jun2012, Vol. 42 Issue 6, p1131-1149. 19p.
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  Data: <searchLink fieldCode="DE" term="%22Antidepressants%22">Antidepressants</searchLink><br /><searchLink fieldCode="DE" term="%22Mental+depression%22">Mental depression</searchLink><br /><searchLink fieldCode="DE" term="%22Citalopram%22">Citalopram</searchLink><br /><searchLink fieldCode="DE" term="%22Outpatient+medical+care%22">Outpatient medical care</searchLink><br /><searchLink fieldCode="DE" term="%22Analysis+of+variance%22">Analysis of variance</searchLink><br /><searchLink fieldCode="DE" term="%22Chi-squared+test%22">Chi-squared test</searchLink><br /><searchLink fieldCode="DE" term="%22Longitudinal+method%22">Longitudinal method</searchLink><br /><searchLink fieldCode="DE" term="%22Classification+of+mental+disorders%22">Classification of mental disorders</searchLink><br /><searchLink fieldCode="DE" term="%22Health+outcome+assessment%22">Health outcome assessment</searchLink><br /><searchLink fieldCode="DE" term="%22Patients%22">Patients</searchLink><br /><searchLink fieldCode="DE" term="%22Questionnaires%22">Questionnaires</searchLink><br /><searchLink fieldCode="DE" term="%22Research+funding%22">Research funding</searchLink><br /><searchLink fieldCode="DE" term="%22Scales+%28Weighing+instruments%29%22">Scales (Weighing instruments)</searchLink><br /><searchLink fieldCode="DE" term="%22Self-evaluation%22">Self-evaluation</searchLink><br /><searchLink fieldCode="DE" term="%22Statistics%22">Statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Survival+analysis+%28Biometry%29%22">Survival analysis (Biometry)</searchLink><br /><searchLink fieldCode="DE" term="%22Disease+relapse%22">Disease relapse</searchLink><br /><searchLink fieldCode="DE" term="%22Logistic+regression+analysis%22">Logistic regression analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Data+analysis%22">Data analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Treatment+effectiveness%22">Treatment effectiveness</searchLink><br /><searchLink fieldCode="DE" term="%22Data+analysis+software%22">Data analysis software</searchLink><br /><searchLink fieldCode="DE" term="%22Kaplan-Meier+estimator%22">Kaplan-Meier estimator</searchLink><br /><searchLink fieldCode="DE" term="%22Therapeutics%22">Therapeutics</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: BackgroundMajor depressive disorder (MDD) is commonly chronic and/or recurrent. We aimed to determine whether a chronic and/or recurrent course of MDD is associated with acute and longer-term MDD treatment outcomes.MethodThis cohort study recruited out-patients aged 18–75 years with non-psychotic MDD from 18 primary and 23 psychiatric care clinics across the USA. Participants were grouped as: chronic (index episode >2 years) and recurrent (n=398); chronic non-recurrent (n=257); non-chronic recurrent (n=1614); and non-chronic non-recurrent (n=387). Acute treatment was up to 14 weeks of citalopram (⩽60 mg/day) with up to 12 months of follow-up treatment. The primary outcomes for this report were remission [16-item Quick Inventory of Depressive Symptomatology – Self-Rated (QIDS-SR16) ⩽5] or response (⩾50% reduction from baseline in QIDS-SR16) and time to first relapse [first QIDS-SR16 by Interactive Voice Response (IVR) ⩾11].ResultsMost participants (85%) had a chronic and/or recurrent course; 15% had both. Chronic index episode was associated with greater sociodemographic disadvantage. Recurrent course was associated with earlier age of onset and greater family histories of depression and substance abuse. Remission rates were lowest and slowest for those with chronic index episodes. For participants in remission entering follow-up, relapse was most likely for the chronic and recurrent group, and least likely for the non-chronic, non-recurrent group. For participants not in remission when entering follow-up, prior course was unrelated to relapse.ConclusionsRecurrent MDD is the norm for out-patients, of whom 15% also have a chronic index episode. Chronic and recurrent course of MDD may be useful in predicting acute and long-term MDD treatment outcomes. [ABSTRACT FROM PUBLISHER]
– Name: AbstractSuppliedCopyright
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  Data: <i>Copyright of Psychological Medicine is the property of Cambridge University Press and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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      – Type: doi
        Value: 10.1017/S0033291711002170
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        Text: English
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      – SubjectFull: Antidepressants
        Type: general
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