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Response rate profiles for major depressive disorder: Characterizing early response and longitudinal nonresponse
Author(s) -
Kelley Mary E.,
Dunlop Boadie W.,
Nemeroff Charles B.,
Lori Adriana,
CarrilloRoa Tania,
Binder Elisabeth B.,
Kutner Michael H.,
Rivera Vivianne Aponte,
Craighead W. Edward,
Mayberg Helen S.
Publication year - 2018
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.22832
Subject(s) - escitalopram , major depressive disorder , clinical psychology , psychology , depression (economics) , medicine , psychiatry , cognition , antidepressant , anxiety , macroeconomics , economics
Background Definition of response is critical when seeking to establish valid predictors of treatment success. However, response at the end of study or endpoint only provides one view of the overall clinical picture that is relevant in testing for predictors. The current study employed a classification technique designed to group subjects based on their rate of change over time, while simultaneously addressing the issue of controlling for baseline severity. Methods A set of latent class trajectory analyses, incorporating baseline level of symptoms, were performed on a sample of 344 depressed patients from a clinical trial evaluating the efficacy of cognitive behavior therapy and two antidepressant medications (escitalopram and duloxetine) in patients with major depressive disorder. Results Although very few demographic and illness‐related features were associated with response rate profiles, the aggregated effect of candidate genetic variants previously identified in large pharmacogenetic studies and meta‐analyses showed a significant association with early remission as well as nonresponse. These same genetic scores showed a less compelling relationship with endpoint response categories. In addition, consistent nonresponse throughout the study treatment period was shown to occur in different subjects than endpoint nonresponse, which was verified by follow‐up augmentation treatment outcomes. Conclusions When defining groups based on the rate of change, controlling for baseline depression severity may help to identify the clinically relevant distinctions of early response on one end and consistent nonresponse on the other.