Treatment response for acute depression is not associated with number of previous episodes: lack of evidence for a clinical staging model for major depressive disorder

Dodd, Seetal, Berk, Michael, Kelin, Katarina, Mancini, Michele and Schacht, Alexander 2013, Treatment response for acute depression is not associated with number of previous episodes: lack of evidence for a clinical staging model for major depressive disorder, Journal of affective disorders, vol. 150, pp. 344-349.

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Title Treatment response for acute depression is not associated with number of previous episodes: lack of evidence for a clinical staging model for major depressive disorder
Author(s) Dodd, Seetal
Berk, Michael
Kelin, Katarina
Mancini, Michele
Schacht, Alexander
Journal name Journal of affective disorders
Volume number 150
Start page 344
End page 349
Total pages 6
Publisher Elsevier BV
Place of publication Amsterdam, The Netherlands
Publication date 2013
ISSN 0165-0327
1573-2517
Keyword(s) depression
treatment
staging
antidepressant
meta-analysis
Summary Mental illness has been observed to follow a neuroprogressive course, commencing with prodrome, then onset, recurrence and finally chronic illness. In bipolar disorder and schizophrenia responsiveness to treatment mirrors these stages of illness progression, with greater response to treatment in the earlier stages of illness and greater treatment resistance in chronic late stage illness.

Using data from 5627 participants in 15 controlled trials of duloxetine, comparator arm (paroxetine, venlafaxine, escitalopram) or placebo for the treatment of an acute depressive episode, the relationship between treatment response and number of previous depressive episodes was determined. Data was dichotomised for comparisons between participants who had >3 previous episodes (n=1697) or ≤3 previous episodes (n=3930), and additionally for no previous episodes (n=1381) or at least one previous episode (n=4246). Analyses were conducted by study arm for each clinical trial, and results were then pooled.

There was no significant difference between treatment response and number of previous depressive episodes. This unexpected finding suggests that treatments to reduce symptoms of depression during acute illness do not lose efficacy for patients with a longer history of illness.
Language eng
Field of Research 119999 Medical and Health Sciences not elsewhere classified
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
HERDC collection year 2013
Persistent URL http://hdl.handle.net/10536/DRO/DU:30055525

Document type: Journal Article
Collection: School of Medicine
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