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Early improvement in positive rather than negative emotion predicts remission from depression after pharmacotherapy
Open accessAbstract
Knowledge on mechanisms involved in early prediction of response to antidepressant medication may help optimize clinical decision making. Recent studies regarding response to pharmacotherapy implicate resilience-like mechanisms and involvement of positive, rather than negative emotions. The aim of the current study is to examine the contribution of early change in positive affect to the prediction of response to pharmacotherapy. Positive and negative emotions were measured at baseline and during the first week of pharmacotherapy, using experience sampling techniques. The association between early change in positive and negative emotions and severity of depressive symptoms at week six was examined in a sample of 49 depressed patients. The added benefits of measuring early change in positive emotions compared to early Hamilton Depression Rating Scale (HDRS) change alone were evaluated through model comparisons. Early improvement in positive affect during the first week of treatment predicted the continuous HDRS score (β=-0.64, p<0.001), response (50% reduction; OR=4.32, p<0.01), and remission (HDRS≤7; OR=9.29, p<0.001) at week six with moderate to large effect sizes. Effects of early change in negative emotions were only half as large and disappeared when evaluated simultaneously with early change in positive emotions. When early change in positive emotions was added to the models including early HDRS change only, all three models improved significantly. In conclusion, early change in positive rather than negative emotions best predicted response to treatment, supporting the notion that antidepressants activate resilience-like mechanisms. Moreover, monitoring of positive emotions in early stages of treatment may improve clinical decision making.
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“Similarly, in individuals recovering from recurrent major depression, a stronger and more lasting inhibitory effect of positive and negative emotions appears to be associated with future recovery 82.”
From Resilience in mental health: linking psychological and neurobiological perspectives. (2013) · cites this paper as [82]
In the citing paper
“Increases in positive emotion (rather than decreases in negative emotion) during the first week of pharmacological treatment in depressed patients predicted improved depression scores and recovery from depression 6 weeks later 70.”
From Resilience in mental health: linking psychological and neurobiological perspectives. (2013) · cites this paper as [70]
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“Furthermore, early increase of positive emotions after start of antidepressant treatment defined by adjectives such as “satisfied,” “enthusiastic,” and “energetic” in a paper by Geschwind et al. predicted response and remission in MDD patients after 6 weeks (Geschwind et al., 2011).”
From Circuit Mechanisms of Reward, Anhedonia, and Depression (2019) · cites this paper as Geschwind et al., 2011
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Metadata
- Authors
- Geschwind, N., Nicolson, N. A., Peeters, F., van Os, J., Barge-Schaapveld, D., & Wichers, M.
- Affiliations
- Maastricht University Medical Centre (NL)
- Corresponding author
- Geschwind, Nicole
- Venue
- European Neuropsychopharmacology
- Publisher
- Elsevier BV
- Published
- 2011-03
- Volume
- 21
- Issue
- 3
- Pages
- 241-247
- ISSN
- 0924-977X (ISSN-L)
- OpenAlex
- W2139889161
- Cited by
- 119
- References
- 31
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 6 · 2023: 4 · 2022: 8 · 2021: 6 · 2020: 7 · 2019: 9 · 2018: 11 · 2017: 14 · 2016: 6 · 2015: 11 · 2014: 11 · 2013: 5 · 2012: 9
- FWCI
- 4.46
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- European Neuropsychopharmacology (publishedVersion)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion, other-oa)
- Pure Amsterdam UMC (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Funders
- Solvay Pharmaceuticals
- Dutch Medical Council (916.76.147)
- Topics
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Keywords
- depression, antidepressant response prediction, positive affect, negative affect, early treatment response, remission, resilience, antidepressant treatment, ecological momentary assessment, Hamilton Depression Rating Scale, treatment monitoring
- MeSH terms
- Adult, Affect, Antidepressive Agents, Major Depressive Disorder, Dose-Response Relationship, Drug, Double-Blind Method, Emotions, Female, Humans, Imipramine, Male, Middle Aged, Placebos, Psychiatric Status Rating Scales, Self-Assessment, Time Factors, Treatment Outcome
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