Cited by 234Treatment of Major DepressionElectroconvulsive Therapy StudiesMental Health Treatment and Access

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Prospective, Long-Term, Multicenter Study of the Naturalistic Outcomes of Patients With Treatment-Resistant Depression

Dunner, David L., Rush, A. John, Russell, James M., Burke, Michael, Woodard, Stacy, Wingard, Peggy, Allen, John·2006·The Journal of Clinical Psychiatry

DOI 10.4088/jcp.v67n0501

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Abstract

BACKGROUND: Treatment-resistant depression (TRD) is a long-term, disabling illness. We report on the characteristics and outcomes of a large cohort of patients with a level of treatment resistance that is very substantial and who were treated for 2 years with standard care. METHOD: This 2-year prospective, multicenter, observational study (patients enrolled from January 2001 through July 2004) tracked the outcomes of 124 patients with treatment-resistant, nonpsychotic major depressive disorder (N = 109) or bipolar depressed phase disorder (N = 15) who received treatment as usual (TAU) (i.e., any therapeutic regimen agreed to by patients and psychiatrists, including medications, electroconvulsive therapy [ECT], and psychotherapy). Treatments could be adjusted, started, and stopped as necessary. The primary outcome, treatment response, was defined a priori as > or = 50% improvement from baseline as measured by the 30-item Inventory of Depressive Symptomatology-Self-Report (IDS-SR-30). Remission was defined as an IDS-SR-30 score of < or = 14. The Medical Outcomes Study (MOS) 36-item Short Form Health Survey (SF-36) was used to monitor quality-of-life changes. RESULTS: The 12- and 24-month IDS-SR-30 response rates were 11.6% (13/112) and 18.4% (19/103), respectively. Of the 13 responders at 12 months, only 5 were responders at 24 months. The 12- and 24-month IDS-SR-30 remission rates were 3.6% (4/112) and 7.8% (8/103), respectively. Only 1 of the 4 12-month remitters was also a remitter at 24 months. The SF-36 indicated globally poor quality of life in this sample. CONCLUSIONS: Despite the wide range of treatment options available for depression, the response rates, remission rates, and quality-of-life results in this study show that most patients with a substantial degree of treatment resistance continue to have significant symptomatology and functional disability when receiving TAU.

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Authors: Dunner, D. L., Rush, A. J., Russell, J. M., Burke, M., Woodard, S., Wingard, P., & Allen, J.
Affiliations: The University of Texas Southwestern Medical Center (US)
Eli Lilly (United States) (US)
University of Kansas (US)
IQVIA (United States) (US)
ORCID: Rush, A. John
Burke, Michael
Venue: The Journal of Clinical Psychiatry
Publisher: Physicians Postgraduate Press, Inc
Published: 2006-05-15
Volume: 67
Issue: 05
Pages: 688-695
ISSN: 0160-6689 (ISSN-L)
DOI: 10.4088/jcp.v67n0501
OpenAlex: W1978161441
Cited by: 234
References: 0
Citations by year: 2026: 10 · 2025: 9 · 2024: 14 · 2023: 10 · 2022: 23 · 2021: 11 · 2020: 13 · 2019: 14 · 2018: 22 · 2017: 11 · 2016: 10 · 2015: 6 · 2014: 10 · 2013: 9 · 2012: 13
FWCI: 5.85
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 › Electroconvulsive Therapy Studies
Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Keywords: treatment-resistant depression, major depressive disorder, bipolar depression, treatment response, remission, quality of life, functional disability, long-term outcomes, usual care, electroconvulsive therapy, psychotherapy, antidepressant treatment
MeSH terms: Adolescent, Adult, Aged, Aged, 80 and over, Antidepressive Agents, Bipolar Disorder, Major Depressive Disorder, Depressive Disorder, Drug Resistance, Electroconvulsive Therapy, Health Status, Humans, Longitudinal Studies, Middle Aged, Personality Inventory, Prospective Studies, Psychiatric Status Rating Scales, Psychotherapy, Psychotropic Drugs, Quality of Life, Surveys and Questionnaires, Recurrence, Cohort Studies, Treatment Outcome

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Prospective, Long-Term, Multicenter Study of the Naturalistic Outcomes of Patients With Treatment-Resistant Depression

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