Clinical predictors in major depressive disorder

Remission is the goal for current depression treatment. However, the Sequenced Treatment Alternatives to Relieve Depression study has shown that the majority of patients will fail to achieve remission with a first-line antidepressant agent. Previous research has attempted to identify which depression treatments are preferred for whom by assessing baseline predictors. Of predictors, sex, age, severity of illness, depressive subtype, and comorbidity have predicted treatment response/nonresponse. However, these predictors have not always provided meaningful clinical correlation. Furthermore, based on the results of recent research, it is clear that clinicians need predictive variables to identify "next-best" preferred depression treatments for patients. This article defines these predictive variables as process predictors, in that they include factors that occur during the treatment process and are associated with outcomes.