Response rate profiles for major depressive disorder: Characterizing early response and longitudinal nonresponse

Mary E. Kelley, Boadie W. Dunlop, Charles Nemeroff, Adriana Lori, Tania Carrillo-Roa, Elisabeth B. Binder, Michael H. Kutner, Vivianne Aponte Rivera, W. Edward Craighead, Helen S. Mayberg

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Definition of response is critical when seeking to establish valid predictors of treatment success. However, response at the end of study or endpoint only provides one view of the overall clinical picture that is relevant in testing for predictors. The current study employed a classification technique designed to group subjects based on their rate of change over time, while simultaneously addressing the issue of controlling for baseline severity. Methods: A set of latent class trajectory analyses, incorporating baseline level of symptoms, were performed on a sample of 344 depressed patients from a clinical trial evaluating the efficacy of cognitive behavior therapy and two antidepressant medications (escitalopram and duloxetine) in patients with major depressive disorder. Results: Although very few demographic and illness-related features were associated with response rate profiles, the aggregated effect of candidate genetic variants previously identified in large pharmacogenetic studies and meta-analyses showed a significant association with early remission as well as nonresponse. These same genetic scores showed a less compelling relationship with endpoint response categories. In addition, consistent nonresponse throughout the study treatment period was shown to occur in different subjects than endpoint nonresponse, which was verified by follow-up augmentation treatment outcomes. Conclusions: When defining groups based on the rate of change, controlling for baseline depression severity may help to identify the clinically relevant distinctions of early response on one end and consistent nonresponse on the other.

Original languageEnglish (US)
JournalDepression and Anxiety
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Major Depressive Disorder
Citalopram
Cognitive Therapy
Antidepressive Agents
Meta-Analysis
Demography
Clinical Trials
Depression
Therapeutics
Pharmacogenomic Testing
Duloxetine Hydrochloride

Keywords

  • antidepressants
  • CBT/cognitive behavior therapy
  • depression
  • genetics
  • treatment

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

Cite this

Response rate profiles for major depressive disorder : Characterizing early response and longitudinal nonresponse. / Kelley, Mary E.; Dunlop, Boadie W.; Nemeroff, Charles; Lori, Adriana; Carrillo-Roa, Tania; Binder, Elisabeth B.; Kutner, Michael H.; Rivera, Vivianne Aponte; Craighead, W. Edward; Mayberg, Helen S.

In: Depression and Anxiety, 01.01.2018.

Research output: Contribution to journalArticle

Kelley, ME, Dunlop, BW, Nemeroff, C, Lori, A, Carrillo-Roa, T, Binder, EB, Kutner, MH, Rivera, VA, Craighead, WE & Mayberg, HS 2018, 'Response rate profiles for major depressive disorder: Characterizing early response and longitudinal nonresponse', Depression and Anxiety. https://doi.org/10.1002/da.22832
Kelley, Mary E. ; Dunlop, Boadie W. ; Nemeroff, Charles ; Lori, Adriana ; Carrillo-Roa, Tania ; Binder, Elisabeth B. ; Kutner, Michael H. ; Rivera, Vivianne Aponte ; Craighead, W. Edward ; Mayberg, Helen S. / Response rate profiles for major depressive disorder : Characterizing early response and longitudinal nonresponse. In: Depression and Anxiety. 2018.
@article{6638920bec6c40bba49245ac2935cd49,
title = "Response rate profiles for major depressive disorder: Characterizing early response and longitudinal nonresponse",
abstract = "Background: Definition of response is critical when seeking to establish valid predictors of treatment success. However, response at the end of study or endpoint only provides one view of the overall clinical picture that is relevant in testing for predictors. The current study employed a classification technique designed to group subjects based on their rate of change over time, while simultaneously addressing the issue of controlling for baseline severity. Methods: A set of latent class trajectory analyses, incorporating baseline level of symptoms, were performed on a sample of 344 depressed patients from a clinical trial evaluating the efficacy of cognitive behavior therapy and two antidepressant medications (escitalopram and duloxetine) in patients with major depressive disorder. Results: Although very few demographic and illness-related features were associated with response rate profiles, the aggregated effect of candidate genetic variants previously identified in large pharmacogenetic studies and meta-analyses showed a significant association with early remission as well as nonresponse. These same genetic scores showed a less compelling relationship with endpoint response categories. In addition, consistent nonresponse throughout the study treatment period was shown to occur in different subjects than endpoint nonresponse, which was verified by follow-up augmentation treatment outcomes. Conclusions: When defining groups based on the rate of change, controlling for baseline depression severity may help to identify the clinically relevant distinctions of early response on one end and consistent nonresponse on the other.",
keywords = "antidepressants, CBT/cognitive behavior therapy, depression, genetics, treatment",
author = "Kelley, {Mary E.} and Dunlop, {Boadie W.} and Charles Nemeroff and Adriana Lori and Tania Carrillo-Roa and Binder, {Elisabeth B.} and Kutner, {Michael H.} and Rivera, {Vivianne Aponte} and Craighead, {W. Edward} and Mayberg, {Helen S.}",
year = "2018",
month = "1",
day = "1",
doi = "10.1002/da.22832",
language = "English (US)",
journal = "Depression and Anxiety",
issn = "1091-4269",
publisher = "Wiley-Blackwell",

}

TY - JOUR

T1 - Response rate profiles for major depressive disorder

T2 - Characterizing early response and longitudinal nonresponse

AU - Kelley, Mary E.

AU - Dunlop, Boadie W.

AU - Nemeroff, Charles

AU - Lori, Adriana

AU - Carrillo-Roa, Tania

AU - Binder, Elisabeth B.

AU - Kutner, Michael H.

AU - Rivera, Vivianne Aponte

AU - Craighead, W. Edward

AU - Mayberg, Helen S.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: Definition of response is critical when seeking to establish valid predictors of treatment success. However, response at the end of study or endpoint only provides one view of the overall clinical picture that is relevant in testing for predictors. The current study employed a classification technique designed to group subjects based on their rate of change over time, while simultaneously addressing the issue of controlling for baseline severity. Methods: A set of latent class trajectory analyses, incorporating baseline level of symptoms, were performed on a sample of 344 depressed patients from a clinical trial evaluating the efficacy of cognitive behavior therapy and two antidepressant medications (escitalopram and duloxetine) in patients with major depressive disorder. Results: Although very few demographic and illness-related features were associated with response rate profiles, the aggregated effect of candidate genetic variants previously identified in large pharmacogenetic studies and meta-analyses showed a significant association with early remission as well as nonresponse. These same genetic scores showed a less compelling relationship with endpoint response categories. In addition, consistent nonresponse throughout the study treatment period was shown to occur in different subjects than endpoint nonresponse, which was verified by follow-up augmentation treatment outcomes. Conclusions: When defining groups based on the rate of change, controlling for baseline depression severity may help to identify the clinically relevant distinctions of early response on one end and consistent nonresponse on the other.

AB - Background: Definition of response is critical when seeking to establish valid predictors of treatment success. However, response at the end of study or endpoint only provides one view of the overall clinical picture that is relevant in testing for predictors. The current study employed a classification technique designed to group subjects based on their rate of change over time, while simultaneously addressing the issue of controlling for baseline severity. Methods: A set of latent class trajectory analyses, incorporating baseline level of symptoms, were performed on a sample of 344 depressed patients from a clinical trial evaluating the efficacy of cognitive behavior therapy and two antidepressant medications (escitalopram and duloxetine) in patients with major depressive disorder. Results: Although very few demographic and illness-related features were associated with response rate profiles, the aggregated effect of candidate genetic variants previously identified in large pharmacogenetic studies and meta-analyses showed a significant association with early remission as well as nonresponse. These same genetic scores showed a less compelling relationship with endpoint response categories. In addition, consistent nonresponse throughout the study treatment period was shown to occur in different subjects than endpoint nonresponse, which was verified by follow-up augmentation treatment outcomes. Conclusions: When defining groups based on the rate of change, controlling for baseline depression severity may help to identify the clinically relevant distinctions of early response on one end and consistent nonresponse on the other.

KW - antidepressants

KW - CBT/cognitive behavior therapy

KW - depression

KW - genetics

KW - treatment

UR - http://www.scopus.com/inward/record.url?scp=85052915291&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85052915291&partnerID=8YFLogxK

U2 - 10.1002/da.22832

DO - 10.1002/da.22832

M3 - Article

C2 - 30260539

AN - SCOPUS:85052915291

JO - Depression and Anxiety

JF - Depression and Anxiety

SN - 1091-4269

ER -