Cited by 20Treatment of Major DepressionMental Health Treatment and AccessAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

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

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Dodd, Seetal, Berk, Michael, Kelin, Katarina, Mancini, Michele, Schacht, Alexander·2013·Journal of Affective Disorders

Abstract

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.

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Crossref · 10.1016/j.jad.2013.04.016

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Authors
Dodd, S., Berk, M., Kelin, K., Mancini, M., & Schacht, A.
Affiliations
  • Deakin University (AU)
  • Mental Health Research Institute (AU)
  • Eli Lilly (Australia) (AU)
  • Eli Lilly (Italy) (IT)
  • Eli Lilly (Germany) (DE)
Corresponding author
Dodd, Seetal
Venue
Journal of Affective Disorders
Publisher
Elsevier BV
Published
2013-09
Volume
150
Issue
2
Pages
344-349
ISSN
0165-0327 (ISSN-L)
OpenAlex
W1986876872
Cited by
20
References
53
Citations by year
2026: 1 · 2025: 2 · 2024: 1 · 2022: 1 · 2021: 2 · 2020: 4 · 2018: 2 · 2017: 1 · 2016: 1 · 2015: 1 · 2014: 3 · 2013: 1
FWCI
1.46
Type
journal article
Language
en
Open access
Locations
  • Journal of Affective Disorders (publishedVersion)
  • PubMed (publishedVersion)
  • Figshare (submittedVersion, cc-by)
Topics
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
major depressive disorder, acute depression, treatment response, clinical staging model, neuroprogression, duloxetine, antidepressant efficacy, treatment resistance, chronic depression, disease history
MeSH terms
Duloxetine Hydrochloride, Venlafaxine Hydrochloride, Acute Disease, Adult, Antidepressive Agents, Cyclohexanols, Depression, Major Depressive Disorder, Female, Humans, Male, Middle Aged, Recurrence, Thiophenes, Time Factors, Citalopram, Treatment Outcome, Paroxetine

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