Treatment resistance in severe unipolar depression: No association with psychotic or melancholic features

Published on May 1, 2013in Annals of Clinical Psychiatry 1.47
Leonardo Zaninotto11
Estimated H-index: 11
,
Daniel Souery45
Estimated H-index: 45
+ 7 AuthorsAlessandro Serretti67
Estimated H-index: 67
Abstract
BACKGROUND: Depressive subtypes generally have been neglected in research on treatment efficacy. We studied a sample of 699 severe unipolar depressed patients to detect any association between depressive features and treatment resistance. METHODS: Participants were divided into psychotic (PSY, n = 90), melancholic (MEL, n = 430) and non-melancholic (n = 179) subjects according to clinical features. Formal diagnostic criteria (Mini International Neuropsychiatric Interview items), and items from 17-item Hamilton Rating Scale for Depression (HRSD17) were compared across groups. Non-responders were defined by a HRSD17 cut-off score of !17 after the last adequate antidepressant treatment. Treatment-resistant depression (TRD) was defined as the failure to respond to !2 adequate antidepressant trials. Non-linear regression models were designed to detect associations between depressive subtypes and TRD. RESULTS: PSY and MEL patients appeared to be more severely affected and to share some "core" melancholic symptoms. Both PSY and MEL patients reported a higher rate of seasonality. However, we found no clinical or illness course variable associated with TRD. CONCLUSIONS: Our results indicate that psychotic and melancholic depression share some "core" melancholia symptoms, while no distinguishing psychopathological feature appears to be associated with TRD in severely depressed patients.
  • References (55)
  • Citations (6)
References55
Published on Oct 1, 1992in American Journal of Psychiatry 13.40
Eric D. Peselow32
Estimated H-index: 32
,
Michael Sanfilipo21
Estimated H-index: 21
+ 1 AuthorsRonald R. Fieve41
Estimated H-index: 41
Objective: The authors'goals were to examine the effects of somatic treatment and platebo in patients with and without endogenous/melancolic depression. Method: Before entry into one of four trials of antidepressant drugs versus platebo, 221 patients were assessed as to whether they met Research Diagnostic Criteria for definite endogenous depression and/or DSM-III criteria for major depressive episode with melancholia
63 Citations Source Cite
Published on Jan 1, 1997in American Journal of Psychiatry 13.40
Christina Sobin24
Estimated H-index: 24
,
Harold A. Sackeim84
Estimated H-index: 84
(Columbia University)
Objective: The authors summarize current knowledge regarding the psychomotor symptoms of depression. Method: Findings from the objective quantification of psychomotor symptoms are reviewed, and methodological issues are considered. The contemporary empirical literature regarding the diagnostic, prognostic, and potential pathophysiologic significance of psychomotor symptoms is summarized. Results: It has been repeatedly shown that depressed patients differ from normal and psychiatric comparison g...
394 Citations Source Cite
Published on Jan 1, 1992in American Journal of Psychiatry 13.40
Alan F. Schatzberg82
Estimated H-index: 82
,
Anthony J. Rothschild39
Estimated H-index: 39
To review data supporting or not supporting the designation of unipolar psychotic major depression as a distinct syndrome in DSM-IV, the authors used computerized literature searches to identify reports of studies that have directly compared the characteristics, biology, familial transmission, course/outcome, and response to treatment of psychotic and nonpsychotic major depression. The review showed that statistically sagnificant differences between the two types of depression have been found on...
248 Citations Source Cite
Published on Feb 1, 2012in Bipolar Disorders 4.49
Bernard J. Carroll58
Estimated H-index: 58
13 Citations Source Cite
Published on Apr 1, 1996in American Journal of Psychiatry 13.40
William Coryell84
Estimated H-index: 84
,
Leon Ac11
Estimated H-index: 11
+ 4 AuthorsDavid A. Solomon46
Estimated H-index: 46
Objective : Most efforts to describe the prognostic significance of psychotic features in depression have been limited to single assessments 1 year or less after the initial evaluation. However, the various biological and treatment response differences between patients with psychotic and nonpsychotic depression suggest that prognostic differences may be very long-term. Method : The 787 patients described here entered the study as they sought treatment at one of five academic medical centers ; th...
113 Citations Source Cite
Published on Jul 1, 2003in Journal of Affective Disorders 3.79
Michael A. Posternak36
Estimated H-index: 36
(Rhode Island Hospital),
Mark Zimmerman66
Estimated H-index: 66
(Rhode Island Hospital)
Background: A patient’s report of their antidepressant treatment history is one of the most important pieces of information used in selecting an antidepressant regimen. It is currently unknown how accurate patients are in describing and characterizing their antidepressant treatment history. Methods: Seventy-three patients receiving treatment for depression at our outpatient psychiatric practice were interviewed by an independent evaluator who was blind to each patient’s treatment history. Inform...
27 Citations Source Cite
Published on Nov 1, 2002in Comprehensive Psychiatry 2.13
Stewart A. Shankman23
Estimated H-index: 23
(Stony Brook University),
Daniel N. Klein71
Estimated H-index: 71
(Stony Brook University)
Abstract It has long been debated whether depression is best classified with a categorical or dimensional diagnostic system. There has been surprisingly little discussion, however, of what the contents of a dimensional classification should include, with most studies employing a single dimension based on symptom severity. The present study explored whether a dimension based on prior course of depression increases the validity of a dimensional model based on symptom severity alone and whether the...
17 Citations Source Cite
Published on Jul 15, 2007in The Journal of Clinical Psychiatry 4.25
Daniel Souery45
Estimated H-index: 45
,
Pierre Oswald14
Estimated H-index: 14
+ 9 AuthorsAlessandro Serretti67
Estimated H-index: 67
OBJECTIVES: Very few studies have investigated clinical features associated with treatment-resistant depression (TRD) defined as failure of at least 2 consecutive antidepressant trials. The primary objective of this multicenter study was to identify specific clinical and demographic factors associated with TRD in a large sample of patients with major depressive episodes that failed to reach response or remission after at least 2 consecutive adequate antidepressant treatments. METHOD: A total of ...
248 Citations Source Cite
Published on Feb 1, 1992in Psychopharmacology 3.22
J. Angst3
Estimated H-index: 3
(University of Zurich),
M. Stabl3
Estimated H-index: 3
(Hoffmann-La Roche)
Whilst tricyclic antidepressants are efficacious in all depressive syndromes, classical MAO-inhibitors differ substantially from them in their action. They are considered less effective in general and not very effective in endogenous depression, but recommended for the treatment of ‘atypical’ depression. A new class of RIMA (Reversible Inhibitors of MAO-A) represented by moclobemide requires a change in clinical thinking on antidepressants. Moclobemide shows the same efficacy in depression as tr...
71 Citations Source Cite
Konstantinos N. Fountoulakis39
Estimated H-index: 39
(Aristotle University of Thessaloniki),
Apostolos Iacovides25
Estimated H-index: 25
(Aristotle University of Thessaloniki)
+ 5 AuthorsGeorge Kaprinis26
Estimated H-index: 26
(Aristotle University of Thessaloniki)
Abstract The aim of the present study was to search for differences between subtypes of major depression with the use of single photon emission tomography. Materials and methods : Fifty (50) patients aged 21–60 years suffering from Major Depression according to DSM-IV took part in the study. The SCAN v 2.0 was used to assist clinical diagnosis. The psychometric assessment included the HDRS, the HAS, the GAF, the Newcastle scales and the Diagnostic Melancholia Scale (DMS). Single Photon Emission ...
54 Citations Source Cite
Cited By6
Published on Nov 1, 2014in Annals of Clinical Psychiatry 1.47
Leonardo Zaninotto11
Estimated H-index: 11
,
Daniel Souery45
Estimated H-index: 45
+ 7 AuthorsAlessandro Serretti67
Estimated H-index: 67
BACKGROUND: Major depression (MD) is currently viewed as a heterogeneous condition, characterized by different psychopathological dimensions. METHODS: Our sample was composed of 1,289 nonpsychotic bipolar/unipolar depressed patients. Participants were divided into mixed (MXD), melancholic (MEL), and anxious (ANX) depressed, according to a hierarchical functional model. Sociodemographic and clinical variables were compared across depressive subtypes by χ2 test and analysis of variance. The Young ...
4 Citations
Published on Jan 1, 2016in Journal of Affective Disorders 3.79
Martina Balestri8
Estimated H-index: 8
(University of Bologna),
Raffaella Calati26
Estimated H-index: 26
(University of Montpellier)
+ 6 AuthorsAlessandro Serretti67
Estimated H-index: 67
(University of Bologna)
Abstract Background Few studies investigated socio-demographic and clinical predictors of non response and remission in treatment resistant depression (TRD) in the case of failure of more than two adequate antidepressant (AD) trial. The primary aim of this study was to investigate socio-demographic and clinical predictors of TRD defined as the lack of response to at least three adequate AD treatments, two of which prospectively evaluated. As secondary aims, we also investigated predictors of non...
20 Citations Source Cite
Ching-Hua Lin12
Estimated H-index: 12
(Kaohsiung Medical University),
Chun-Jen Huang3
Estimated H-index: 3
(Kaohsiung Medical University),
Cheng-Chung Chen19
Estimated H-index: 19
(Kaohsiung Medical University)
1 Citations Source Cite
Published on Dec 1, 2018in BMC Psychiatry 2.42
Nicolas Nuñez2
Estimated H-index: 2
(McGill University),
Stefano Comai17
Estimated H-index: 17
(McGill University)
+ 10 AuthorsNicola Low49
Estimated H-index: 49
(McGill University)
Background Some authors have hypothesized that Treatment-Resistant Unipolar Depression (TRD-UP) should be considered within the bipolar spectrum disorders and that hidden bipolarity may be a risk factor for TRD-UP. However, there are neither studies comparing clinical and sociodemographic data of patients with TRD-UP versus Bipolar (BP) disorders nor are there any examining differences versus Bipolar type I (BP-I) and Bipolar type II (BP-II).
Source Cite
Published on Jul 1, 2018in Pharmacological Reviews 18.96
Filippo Caraci34
Estimated H-index: 34
,
Francesca Calabrese28
Estimated H-index: 28
(University of Milan)
+ 9 AuthorsSiegfried Kasper76
Estimated H-index: 76
(Medical University of Vienna)
Major depressive disorder is one of the most prevalent and life-threatening forms of mental illnesses and a major cause of morbidity worldwide. Currently available antidepressants are effective for most patients, although around 30% are considered treatment resistant (TRD), a condition that is associated with a significant impairment of cognitive function and poor quality of life. In this respect, the identification of the molecular mechanisms contributing to TRD represents an essential step for...
2 Citations Source Cite
Published on Jan 1, 2019in Acta Psychiatrica Scandinavica 4.98
Alexander Kautzky9
Estimated H-index: 9
(Medical University of Vienna),
Markus Dold12
Estimated H-index: 12
(Medical University of Vienna)
+ 12 AuthorsChiara Fabbri17
Estimated H-index: 17
(University of Bologna)
Source Cite