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Epidemiology of Treatment-Resistant Depression in the United States
Abstract
The prevalence of treatment-resistant depression (TRD) among patients with pharmaceutically treated depression (PTD) varies greatly in publications. The aim of this study is to estimate the prevalence of TRD using 2 large claims databases in the US. codes: F32.xx, F33.xx) and 1 antidepressant prescription filled in 2018 were identified as having PTD. Among patients with PTD, TRD was defined as experiencing failure of treatment with at least 2 antidepressants with ≥ 4 weeks of adequate treatment. We estimated the age- and gender-standardized prevalence of TRD and then used logistic regression to investigate if TRD risk varies by age, sex, race, and geographic region. Finally, we described the timeline of TRD development in incident PTD patients. We identified 296,055 and 277,941 patients with PTD in the Humana and Optum databases, among whom 17,640 (6.0%) and 16,131 (5.8%) had TRD. After age and sex standardization, TRD prevalence among PTD patients was 6.8% in Humana vs 5.8% in Optum. Females, middle-aged adults, and White patients had higher risk of TRD. The median time from index antidepressant use to TRD was about 6 months in incident PTD patients. The prevalence of TRD among patients with PTD was similar in the 2 databases. TRD prevalence varies by sex, race, and age, with a higher prevalence in females, White patients, and those in the age group of 45-64 years. However, the absolute differences were small.
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“It is currently estimated that at least 30% of persons with depression meet this definition.”
From Treatment‐resistant depression: definition, prevalence, detection, management, and investigational interventions (2023) · cites this paper as [98]
In the citing paper
“TRD is often stated to af fect approximately 30% of persons receiving antidepressant treatment in research set tings, while its prevalence in real world prac- tice is estimated to range between 6 and 55% 32,98- 101 .”
From Treatment‐resistant depression: definition, prevalence, detection, management, and investigational interventions (2023) · cites this paper as [98]
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Metadata
- Authors
- Liu, X., Mukai, Y., Furtek, C. I., Bortnichak, E. A., Liaw, K.-L., & Zhong, W.
- Affiliations
- Merck & Co., Inc., Rahway, NJ, USA (United States) (US)
- Venue
- The Journal of Clinical Psychiatry
- Publisher
- Physicians Postgraduate Press, Inc
- Published
- 2021-11-30
- Volume
- 83
- Issue
- 1
- ISSN
- 0160-6689 (ISSN-L)
- 1555-2101
- OpenAlex
- W3215685141
- Cited by
- 36
- References
- 0
- Citations by year
- 2026: 2 · 2025: 10 · 2024: 14 · 2023: 9 · 2022: 1
- FWCI
- 3.52
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Disorders
- Keywords
- treatment-resistant depression, prevalence, antidepressant treatment failure, antidepressant prescribing, sex differences, racial differences, age differences, regional variation, claims data
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Antidepressive Agents, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, United States, Prevalence, Databases, Factual, Young Adult, Depressive Disorder, Treatment-Resistant
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