Long-Term Impact of Residual Symptoms in Treatment-Resistant Depression
Open accessAbstract
Objective: Although commonly encountered, little work has defined the longitudinal course of treatment-resistant depression (TRD) and the influence of residual posttreatment symptoms on longer-term outcome. The aim of our study was to assess the impact of posttreatment clinical states on longer-term outcome. Method: Patients ( n = 118) with TRD received specialist inpatient treatment and were followed-up for a median of 3 years. Longitudinal outcome dichotomized into good and poor outcome was used as the primary outcome and functional measures were used as secondary outcomes. Results: Among 118 treated patients, 40 (34%) entered clinical remission, 36 (31%) entered partial remission, and 42 (37%) remained in episode at discharge. At follow-up, 35% had longitudinally defined poor outcome. Posttreatment clinical status was the main predictor of both poor and good outcome. Nearly 50% of patients achieved postdischarge recovery, and subsequently had longer-term outcome, comparable with patients discharged in remission. Patients who remained in episode posttreatment were more symptomatically and functionally impaired. Conclusion: Posttreatment clinical states are a useful guide to clinicians for projecting the longer-term outcome of patients with TRD. The persistence of residual or syndromal symptoms predicts a poorer longer-term outcome, whereas treatment to remission is associated with better outcomes.
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 four follow-up studies had relatively small sample sizes, ranging from 71 to 118, and two involved the same set of participants.
“Overall, sample sizes were relatively small, ranging from 71 to 118, and two of the four studies involved the same set of participants (Fekadu et al., 2011, 2012).”
From Irremediability in psychiatric euthanasia: examining the objective standard (2023) · cites this paper as Fekadu et al., 2011
Fekadu et al. (2011) found that 69% achieved remission or partial remission, with outcomes at follow-up varying according to status at discharge.
“The first study found that 69% achieved remission or partial remission, with outcomes at follow-up (median of 3 years) varying according to the status at discharge (Fekadu et al., 2011).”
From Irremediability in psychiatric euthanasia: examining the objective standard (2023) · cites this paper as Fekadu et al., 2011
Four naturalistic studies focused on medium to long-term outcomes in patients who were explicitly defined as having TRD at beginning of follow-up.
“Four naturalistic studies focused on medium to long-term outcomes in patients who were explicitly defined as having TRD at beginning of follow-up (Fekadu et al., 2011, 2012; Vergunst et al., 2013; Wooderson et al., 2014).”
From Irremediability in psychiatric euthanasia: examining the objective standard (2023) · cites this paper as Fekadu et al., 2011
These four naturalistic studies showed that a majority of included patients, despite being well-characterized as treatment-resistant at onset and after years of community treatment, significantly improved (reached remission).
“These studies showed that included patients, despite being well-characterized as treatment-resistant at the onset of the studies and after having received years of community treatment – i.e., persons with extensive psychiatric histories, comparable those requesting and receiving psychiatric EAS currently (Kim, De Vries, & Peteet, 2016; Nicolini, Peteet, Donovan, & Kim, 2020b; Thienpont et al., 201”
From Irremediability in psychiatric euthanasia: examining the objective standard (2023) · cites this paper as Fekadu et al., 2011
The citation lists haven’t been fetched yet
References 35 · Cited by 23
- Authors
- Fekadu, A., Wooderson, S. C., Rane, L. J., Markopoulou, K., Poon, L., & Cleare, A. J.
- Affiliations
- King's College London (GB)
- National Health Service (GB)
- Corresponding author
- Fekadu, Abebaw
- Venue
- The Canadian Journal of Psychiatry
- Publisher
- SAGE Publications
- Published
- 2011-09
- Volume
- 56
- Issue
- 9
- Pages
- 549-557
- ISSN
- 0706-7437 (ISSN-L)
- 1497-0015
- OpenAlex
- W48357603
- Cited by
- 23
- References
- 35
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 4 · 2023: 3 · 2022: 3 · 2020: 1 · 2019: 1 · 2018: 2 · 2017: 1 · 2014: 1 · 2013: 2 · 2012: 2
- FWCI
- 1.17
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Canadian Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- Funders
- Bristol-Myers Squibb
- Eli Lilly and Company
- GlaxoSmithKline
- NIHR Biomedical Research Centre, Royal Marsden NHS Foundation Trust/Institute of Cancer Research
- National Institute for Health and Care Research
- King's College London
- UCB Pharma
- Topics
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- treatment-resistant depression, residual symptoms, long-term outcomes, remission, partial remission, functional outcome, inpatient care, outcome prediction
- MeSH terms
- Adult, Female, Follow-Up Studies, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Recurrence, Remission Induction, Severity of Illness Index, Treatment Outcome, 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
