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Does early-onset chronic or recurrent major depression impact outcomes with antidepressant medications? A CO-MED Trial Report.

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Title: Does early-onset chronic or recurrent major depression impact outcomes with antidepressant medications? A CO-MED Trial Report.
Authors: Sung, S. C., Wisniewski, S. R., Balasubramani, G. K., Zisook, S., Kurian, B., Warden, D., Trivedi, M. H., Rush, A. J.
Source: Psychological Medicine. May2013, Vol. 43 Issue 5, p945-960. 16p.
Subjects: Mental depression, Age factors in disease, Antidepressants, Chi-squared test, Fisher exact test, Longitudinal method, Health outcome assessment, Questionnaires, Research funding, Statistical sampling, Scales (Weighing instruments), Self-evaluation, Sex distribution, Statistics, T-test (Statistics), Disease relapse, Logistic regression analysis, Randomized controlled trials, Treatment effectiveness, Blind experiment, Severity of illness index, Citalopram, Therapeutics
Abstract: Background. Prior studies have suggested that major depressive disorder (MDD) with pre-adult onset represents a distinct subtype with greater symptom severity and higher rates of suicidal ideation. Whether these patients have poorer response to various types of antidepressant treatment than those with adult-onset MDD is unclear. Method. A total of 665 psychiatric and primary care out-patients (aged 18-75 years) with non-psychotic chronic or recurrent MDD participated in a single-blind, randomized trial that compared the efficacy of escitalopram plus placebo, bupropion sustained-release plus escitalopram, or venlafaxine extended-release plus mirtazapine. We compared participants who self-reported MDD onset (before age 18) to those with a later onset (adult onset) with respect to baseline characteristics and treatment/outcome variables at 12 and 28 weeks. Results. Early-onset chronic/recurrent MDD was associated with a distinct set of sociodemographic (female, younger age) and clinical correlates (longer duration of illness, greater number of prior episodes, greater likelihood of atypical features, higher rates of suicidality and psychiatric co-morbidity, fewer medical problems, poorer quality of life, greater history of child abuse/neglect). However, results from unadjusted and adjusted analyses showed no significant differences in response, remission, tolerability of medications, quality of life, or retention at 12 or 28 weeks. Conclusions. Although early-onset chronic/recurrent MDD is associated with a more severe clinical picture, it does not seem to be useful for predicting differential treatment response to antidepressant medication. Clinicians should remain alert to an increased risk of suicidality in this population. [ABSTRACT FROM AUTHOR]
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: Does early-onset chronic or recurrent major depression impact outcomes with antidepressant medications? A CO-MED Trial Report.
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  Data: <searchLink fieldCode="AR" term="%22Sung%2C+S%2E+C%2E%22">Sung, S. C.</searchLink><br /><searchLink fieldCode="AR" term="%22Wisniewski%2C+S%2E+R%2E%22">Wisniewski, S. R.</searchLink><br /><searchLink fieldCode="AR" term="%22Balasubramani%2C+G%2E+K%2E%22">Balasubramani, G. K.</searchLink><br /><searchLink fieldCode="AR" term="%22Zisook%2C+S%2E%22">Zisook, S.</searchLink><br /><searchLink fieldCode="AR" term="%22Kurian%2C+B%2E%22">Kurian, B.</searchLink><br /><searchLink fieldCode="AR" term="%22Warden%2C+D%2E%22">Warden, D.</searchLink><br /><searchLink fieldCode="AR" term="%22Trivedi%2C+M%2E+H%2E%22">Trivedi, M. H.</searchLink><br /><searchLink fieldCode="AR" term="%22Rush%2C+A%2E+J%2E%22">Rush, A. J.</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22Psychological+Medicine%22">Psychological Medicine</searchLink>. May2013, Vol. 43 Issue 5, p945-960. 16p.
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  Data: <searchLink fieldCode="DE" term="%22Mental+depression%22">Mental depression</searchLink><br /><searchLink fieldCode="DE" term="%22Age+factors+in+disease%22">Age factors in disease</searchLink><br /><searchLink fieldCode="DE" term="%22Antidepressants%22">Antidepressants</searchLink><br /><searchLink fieldCode="DE" term="%22Chi-squared+test%22">Chi-squared test</searchLink><br /><searchLink fieldCode="DE" term="%22Fisher+exact+test%22">Fisher exact test</searchLink><br /><searchLink fieldCode="DE" term="%22Longitudinal+method%22">Longitudinal method</searchLink><br /><searchLink fieldCode="DE" term="%22Health+outcome+assessment%22">Health outcome assessment</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="%22Statistical+sampling%22">Statistical sampling</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="%22Sex+distribution%22">Sex distribution</searchLink><br /><searchLink fieldCode="DE" term="%22Statistics%22">Statistics</searchLink><br /><searchLink fieldCode="DE" term="%22T-test+%28Statistics%29%22">T-test (Statistics)</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="%22Randomized+controlled+trials%22">Randomized controlled trials</searchLink><br /><searchLink fieldCode="DE" term="%22Treatment+effectiveness%22">Treatment effectiveness</searchLink><br /><searchLink fieldCode="DE" term="%22Blind+experiment%22">Blind experiment</searchLink><br /><searchLink fieldCode="DE" term="%22Severity+of+illness+index%22">Severity of illness index</searchLink><br /><searchLink fieldCode="DE" term="%22Citalopram%22">Citalopram</searchLink><br /><searchLink fieldCode="DE" term="%22Therapeutics%22">Therapeutics</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background. Prior studies have suggested that major depressive disorder (MDD) with pre-adult onset represents a distinct subtype with greater symptom severity and higher rates of suicidal ideation. Whether these patients have poorer response to various types of antidepressant treatment than those with adult-onset MDD is unclear. Method. A total of 665 psychiatric and primary care out-patients (aged 18-75 years) with non-psychotic chronic or recurrent MDD participated in a single-blind, randomized trial that compared the efficacy of escitalopram plus placebo, bupropion sustained-release plus escitalopram, or venlafaxine extended-release plus mirtazapine. We compared participants who self-reported MDD onset (before age 18) to those with a later onset (adult onset) with respect to baseline characteristics and treatment/outcome variables at 12 and 28 weeks. Results. Early-onset chronic/recurrent MDD was associated with a distinct set of sociodemographic (female, younger age) and clinical correlates (longer duration of illness, greater number of prior episodes, greater likelihood of atypical features, higher rates of suicidality and psychiatric co-morbidity, fewer medical problems, poorer quality of life, greater history of child abuse/neglect). However, results from unadjusted and adjusted analyses showed no significant differences in response, remission, tolerability of medications, quality of life, or retention at 12 or 28 weeks. Conclusions. Although early-onset chronic/recurrent MDD is associated with a more severe clinical picture, it does not seem to be useful for predicting differential treatment response to antidepressant medication. Clinicians should remain alert to an increased risk of suicidality in this population. [ABSTRACT FROM AUTHOR]
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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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        Value: 10.1017/S0033291712001742
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        Text: English
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      – SubjectFull: Mental depression
        Type: general
      – SubjectFull: Age factors in disease
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      – SubjectFull: Antidepressants
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      – SubjectFull: Chi-squared test
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      – SubjectFull: Fisher exact test
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      – SubjectFull: Health outcome assessment
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      – SubjectFull: Statistical sampling
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      – SubjectFull: Sex distribution
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      – SubjectFull: Statistics
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      – SubjectFull: Citalopram
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