The Dutch Measure for quantification of Treatment Resistance in Depression (DM-TRD): an extension of the Maudsley Staging Method
Open accessAbstract
Background Treatment resistant depression (TRD) is common in daily practice. An empirical, widely accepted and applicable measure to quantify TRD is lacking. Previously, the Maudsley Staging Method (MSM) showed good validity. We aimed to improve the MSM by refining and extending its items resulting in the Dutch Measure for quantification of TRD (DM-TRD). Methods In addition to duration, severity and failed treatments in the current depressive episode, we added items for functional impairment, comorbid anxiety, personality disorders and psychosocial stressors. We extended the augmentation section and added items for failed psychotherapy and intensified treatment. We examined psychometric properties of the DM-TRD and tested prediction of future depressive symptoms and remission after 16 weeks in 274 (DSM-IV) depressed in- and outpatients entering naturalistic treatment. Results The DM-TRD showed excellent inter-/intra-rater reliability. Higher scores were associated with more symptoms and less remission during follow-up. The DM-TRD outperformed the MSM in prediction of future depressive symptomatology. Remission was predicted equally well by both measures. Longer duration of the current episode, larger functional impairment and larger baseline symptom severity were the strongest predictors of symptomatology at follow-up. Longer duration and larger functional impairment were negatively associated with remission. Limitations Longer follow-up could have increased predictive power. Addition of items for somatic co-morbidity, childhood adversity and psychotic features must be investigated further. Conclusion The DM-TRD has excellent psychometric properties and better predictive validity for clinical outcome than other sophisticated measure published to date. Its use in clinical practice and research will improve treatment planning in TRD-patients.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The predictive validity of the DM-TRD model has been supported to some extent.
“The predictive validity of the model has been supported to some extent 61 .”
From Treatment‐resistant depression: definition, prevalence, detection, management, and investigational interventions (2023) · cites this paper as [61]
Cites
Comparison of Beck Depression Inventories -IA and -II in psychiatric outpatients
Beck, A. T., Steer, R. A., Ball, R., & Ranieri, W. F. (1996) · Journal of Personality Assessment · doi:10.1207/s15327752jpa6703_13 · Cited by 5,965 · see citing works
Rush, A. J., Trivedi, M. H., Wisniewski, S. R., Nierenberg, A. A., Stewart, J. W., Warden, D., Niederehe, G., Thase, M. E., Lavori, P. W., Lebowitz, B. D., et al. (2006) · American Journal of Psychiatry · doi:10.1176/ajp.2006.163.11.1905 · Cited by 5,643 · see citing works
Mediators and Moderators of Treatment Effects in Randomized Clinical Trials
Kraemer, H. C., Wilson, G. T., Fairburn, C. G., & Agras, W. S. (2002) · Archives of General Psychiatry · doi:10.1001/archpsyc.59.10.877 · Cited by 2,562 · cited 1× · see citing works
“Such instrument mimic staging and profiling-measures that are increasingly used in other areas of medicine like oncology, which aim to predict course and prognosis, supporting clinicians in selecting the most effective treatment for a particular patient (Hetrick et al., 2008; Kraemer et al., 2002).”
BackgroundThe Work and Social Adjustment Scale: a simple measure of impairment in functioning
Mundt, J. C., Marks, I. M., Shear, M. K., & Greist, J. M. (2002) · British Journal of Psychiatry · doi:10.1192/bjp.180.5.461 · Cited by 2,515 · see citing works
Cuijpers, P., Sijbrandij, M., Koole, S. L., Andersson, G., Beekman, A. T., & Reynolds, C. F. (2013) · World Psychiatry · doi:10.1002/wps.20038 · Cited by 540 · see citing works
Development and validation of the overall depression severity and impairment scale
Bentley, K. H., Gallagher, M. W., Carl, J. R., & Barlow, D. H. (2014) · Psychological Assessment · doi:10.1037/a0036216 · Cited by 365 · see citing works
The importance of childhood trauma and childhood life events for chronicity of depression in adults
Wiersma, J. E., Hovens, J. G. F. M., van Oppen, P., Giltay, E. J., van Schaik, D. J. F., Beekman, A. T. F., & Penninx, B. W. J. H. (2009) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.08m04521 · Cited by 358 · cited 2× · see citing works
“…does not include the presence of somatic co-morbidity (Rayner et al., 2010; van Milligen et al., 2012), childhood adversity (Tunnard et al., 2014; Wiersma et al., 2009) and sub threshold psychotic features (Perlis et al., 2011; Wigman et al., 2014), all candidate variables also negatively…”
BackgroundSzegedi, A., Jansen, W. T., van Willigenburg, A. P. P., van der Meulen, E., Stassen, H. H., & Thase, M. E. (2009) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.07m03780 · Cited by 341 · cited 2× · see citing works
“For example, the NICE guideline (www.nice.org. uk/guidance/qs8) states that a minimum period of 6–8 weeks is required to assess effectiveness, however other reports advocate earlier switching (after 2 weeks) when insufficient early response is achieved (Szegedi et al., 2009; Tadic et al., 2016).”
BackgroundDisability in depression and back pain
Chwastiak, L. A., & Von Korff, M. (2003) · Journal of Clinical Epidemiology · doi:10.1016/s0895-4356(03)00051-9 · Cited by 280 · see citing works
Skodol, A. E., Grilo, C. M., Keyes, K. M., Geier, T., Grant, B. F., & Hasin, D. S. (2011) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2010.10050695 · Cited by 225 · see citing works
Staging methods for treatment resistant depression. A systematic review
Ruhé, H. G., van Rooijen, G., Spijker, J., Peeters, F. P. M. L., & Schene, A. H. (2012) · Journal of Affective Disorders · doi:10.1016/j.jad.2011.02.020 · Cited by 210 · see citing works
Self-citationZhou, X., Ravindran, A. V., Qin, B., Del Giovane, C., Li, Q., Bauer, M., Liu, Y., Fang, Y., da Silva, T., Zhang, Y., et al. (2015) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.14r09204 · Cited by 189 · see citing works
Early Identification and Intervention in Depressive Disorders: Towards a Clinical Staging Model
Hetrick, S. E., Parker, A. G., Hickie, I. B., Purcell, R., Yung, A. R., & McGorry, P. D. (2008) · Psychotherapy and Psychosomatics · doi:10.1159/000140085 · Cited by 186 · cited 2× · see citing works
“Such instrument mimic staging and profiling-measures that are increasingly used in other areas of medicine like oncology, which aim to predict course and prognosis, supporting clinicians in selecting the most effective treatment for a particular patient (Hetrick et al., 2008; Kraemer et al., 2002).”
BackgroundParikh, S. V., Segal, Z. V., Grigoriadis, S., Ravindran, A. V., Kennedy, S. H., Lam, R. W., & Patten, S. B. (2009) · Journal of Affective Disorders · doi:10.1016/j.jad.2009.06.042 · Cited by 183 · cited 2× · see citing works
“We added scores for previous psychotherapy treatment, as well for the present episode, because meta-analyses and current MDD-guidelines clearly advocate psychotherapy as efficacious as pharmacotherapy (Cuijpers et al., 2013; NICE, 2009; Parikh et al., 2009).”
MethodFekadu, A., Wooderson, S. C., Markopoulou, K., & Cleare, A. J. (2009) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.08m04728 · Cited by 125 · see citing works
LESKELÄ, U., RYTSÄLÄ, H., KOMULAINEN, E., MELARTIN, T., SOKERO, P., LESTELÄ-MIELONEN, P., & ISOMETSÄ, E. (2006) · Psychological Medicine · doi:10.1017/s0033291706007276 · Cited by 105 · see citing works
Brakemeier, E.-L., Radtke, M., Engel, V., Zimmermann, J., Tuschen-Caffier, B., Hautzinger, M., Schramm, E., Berger, M., & Normann, C. (2015) · Psychotherapy and Psychosomatics · doi:10.1159/000369586 · Cited by 94 · see citing works
Ito, M., Bentley, K. H., Oe, Y., Nakajima, S., Fujisato, H., Kato, N., Miyamae, M., Kanie, A., Horikoshi, M., & Barlow, D. H. (2015) · PLoS ONE · doi:10.1371/journal.pone.0122969 · Cited by 76 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
McIntyre, R. S., Alsuwaidan, M., Baune, B. T., Berk, M., Demyttenaere, K., Goldberg, J. F., Gorwood, P., Ho, R., Kasper, S., Kennedy, S. H., et al. (2023) · World Psychiatry · doi:10.1002/wps.21120 · Cited by 836 · see citing works
Brown, S., Rittenbach, K., Cheung, S., McKean, G., MacMaster, F. P., & Clement, F. (2019) · The Canadian Journal of Psychiatry · doi:10.1177/0706743719828965 · Cited by 151 · see citing works
Kautzky, A., Dold, M., Bartova, L., Spies, M., Kranz, G. S., Souery, D., Montgomery, S., Mendlewicz, J., Zohar, J., Fabbri, C., et al. (2019) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.12959 · Cited by 148 · see citing works
Cladder-Micus, M. B., Speckens, A. E. M., Vrijsen, J. N., T. Donders, A. R., Becker, E. S., & Spijker, J. (2018) · Depression and Anxiety · doi:10.1002/da.22788 · Cited by 141 · see citing works
Self-citationvan Bronswijk, S., Moopen, N., Beijers, L., Ruhe, H. G., & Peeters, F. (2019) · Psychological Medicine · doi:10.1017/s003329171800199x · Cited by 128 · see citing works
Self-citationSackeim, H. A., Aaronson, S. T., Bunker, M. T., Conway, C. R., Demitrack, M. A., George, M. S., Prudic, J., Thase, M. E., & Rush, A. J. (2019) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2019.03.021 · Cited by 109 · see citing works
Standardisation framework for the Maudsley staging method for treatment resistance in depression
Fekadu, A., Donocik, J. G., & Cleare, A. J. (2018) · BMC Psychiatry · doi:10.1186/s12888-018-1679-x · Cited by 106 · see citing works
Nie, Z., Vairavan, S., Narayan, V. A., Ye, J., & Li, Q. S. (2018) · PLOS ONE · doi:10.1371/journal.pone.0197268 · Cited by 62 · see citing works
Aligning the many definitions of treatment resistance in anxiety disorders: A systematic review
Bokma, W. A., Wetzer, G. A. A. M., Gehrels, J. B., Penninx, B. W. J. H., Batelaan, N. M., & Balkom, A. L. J. M. (2019) · Depression and Anxiety · doi:10.1002/da.22895 · Cited by 58 · see citing works
The Neglected Role of Psychotherapy for Treatment-Resistant Depression
Markowitz, J. C., Wright, J. H., Peeters, F., Thase, M. E., Kocsis, J. H., & Sudak, D. M. (2022) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2021.21050535 · Cited by 41 · see citing works
Self-citationRooney, W., Schuklenk, U., & van de Vathorst, S. (2018) · Health Care Analysis · doi:10.1007/s10728-017-0344-8 · Cited by 44 · see citing works
- Authors
- Peeters, F. P. M. L., Ruhe, H. G., Wichers, M., Abidi, L., Kaub, K., van der Lande, H. J., Spijker, J., Huibers, M. J. H., & Schene, A. H.
- Affiliations
- Maastricht University (NL)
- University Medical Center Groningen (NL)
- Amsterdam UMC Location University of Amsterdam (NL)
- Pro Persona (NL)
- Vrije Universiteit Amsterdam (NL)
- Radboud University Nijmegen (NL)
- Corresponding author
- Peeters, Frenk P.M.L.
- ORCID
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2016-11
- Volume
- 205
- Pages
- 365-371
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W2516931522
- Cited by
- 72
- References
- 18
- Citations by year
- 2026: 9 · 2025: 9 · 2024: 7 · 2023: 8 · 2022: 9 · 2021: 7 · 2020: 6 · 2019: 8 · 2018: 8 · 2017: 1
- FWCI
- 4.59
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion, other-oa)
- Radboud Repository (Radboud University) (publishedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- VU Research Portal (submittedVersion)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Funders
- ZonMw (016.126.059)
- Nederlandse Organisatie voor Wetenschappelijk Onderzoek (016.126.059;)
- Topics
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- treatment-resistant depression, functional disability, anxiety comorbidity, personality disorders, psychosocial stressors, augmentation therapy, remission prediction, depressive episode duration, psychometric properties
- MeSH terms
- Adult, Antidepressive Agents, Anxiety Disorders, Female, Humans, Male, Netherlands, Personality Disorders, Psychiatric Status Rating Scales, Psychometrics, Psychotherapy, Stress, Psychological, Reproducibility of Results, Comorbidity, Treatment Failure, Depressive Disorder, Treatment-Resistant
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
