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COMPREHENSIVE REVIEW OF FACTORS IMPLICATED IN THE HETEROGENEITY OF RESPONSE IN DEPRESSION
Author(s) -
Carter Gebra Cuyún,
Cantrell Ronald A,
Haynes Virginia S,
Phillips Glenn,
Alatorre Carlos I,
Goetz Iris,
Paczkowski Rosirene,
Marangell Lauren B
Publication year - 2012
Publication title -
depression and anxiety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.634
H-Index - 129
eISSN - 1520-6394
pISSN - 1091-4269
DOI - 10.1002/da.21918
Subject(s) - depression (economics) , medicine , antidepressant , anxiety , meta analysis , clinical psychology , disease , psychiatry , systematic review , medline , psychology , political science , law , economics , macroeconomics
Background Heterogeneity in overall response and outcomes to pharmacological treatment has been reported in several depression studies but with few sources that integrate these results. The goal of this study was to review the literature and attempt to identify nongenetic factors potentially predictive of overall response to depression treatments. Methods A comprehensive review of the literature from the last 10 years was performed using three key databases ( P ub M ed, EMBASE , and C ochrane). All relevant studies that met the inclusion criteria were selected and scored for their levels of evidence using the NICE scoring method. A subjective assessment of the strength of evidence for each factor was performed using predefined criteria. Results Our broad search yielded 76 articles relevant to treatment heterogeneity. Sociodemographic factors, disease characteristics, and comorbidities were the most heavily researched areas. Some of the factors associated with more favorable overall response include being married, other social support, and low levels of baseline depressive symptoms. Evidence relating to baseline disease severity as a factor predictive of antidepressant response was particularly convincing among the factors reviewed. The presence of comorbid anxiety and pain contributed to worse antidepressant treatment outcomes. Conclusions Several factors either predictive of or associated with overall response to antidepressant treatment have been identified. Inclusion of factors predictive of response in the design of future trials may help tailor treatments to depression patients presenting to the average clinical practice, resulting in improved outcomes.