TY - JOUR
T1 - Response to a selective serotonin reuptake inhibitor (citalopram) in major depressive disorder with melancholic features
T2 - A STAR*D report
AU - McGrath, Patrick J.
AU - Khan, Ahsan Y.
AU - Trivedi, Madhukar H.
AU - Stewart, Jonathan W.
AU - Morris, David W.
AU - Wisniewski, Stephen R.
AU - Miyahara, Sachiko
AU - Nierenberg, Andrew A.
AU - Fava, Maurizio
AU - Rush, A. John
PY - 2008/12
Y1 - 2008/12
N2 - Objective: This study examined demographic and clinical correlates of DSM-IV major depressive disorder with melancholic features and assessed whether melancholic features were predictive of response to a selective serotonin reuptake inhibitor antidepressant. Method: Participants with major depressive disorder (N = 2875) at primary and specialty care sites who received the first step treatment with citalopram in the Sequenced Treatment Alternatives to Relieve Depression study were included. Patients were enrolled between July 2001 and April 2004. Melancholic features were ascribed by previously developed algorithms of telephone interview ratings prior to treatment. Demographics, clinical features, and treatment response were compared between those with and without melancholic features. Results: The 23.5% of participants with melancholic features were characterized by higher severity scores, greater rates of previous suicide attempts and ratings of current suicidal risk, and more concurrent psychiatric comorbidity. Unadjusted remission rates for those with melancholic features were statistically significantly reduced in absolute terms by up to 8.4% compared to those without melancholic features, which is a 24.1% decrease in relative chance of remission (p < .0001). Following adjustments for betweengroup baseline differences, remission rates were no longer different. Conclusion: Melancholic features are associated with a significantly reduced remission rate with an SSRI. This effect appears to be accounted for by demographic and clinical features associated with melancholic features. Trial Registration: clinicaltrials.gov Identifier: NCT0021528.
AB - Objective: This study examined demographic and clinical correlates of DSM-IV major depressive disorder with melancholic features and assessed whether melancholic features were predictive of response to a selective serotonin reuptake inhibitor antidepressant. Method: Participants with major depressive disorder (N = 2875) at primary and specialty care sites who received the first step treatment with citalopram in the Sequenced Treatment Alternatives to Relieve Depression study were included. Patients were enrolled between July 2001 and April 2004. Melancholic features were ascribed by previously developed algorithms of telephone interview ratings prior to treatment. Demographics, clinical features, and treatment response were compared between those with and without melancholic features. Results: The 23.5% of participants with melancholic features were characterized by higher severity scores, greater rates of previous suicide attempts and ratings of current suicidal risk, and more concurrent psychiatric comorbidity. Unadjusted remission rates for those with melancholic features were statistically significantly reduced in absolute terms by up to 8.4% compared to those without melancholic features, which is a 24.1% decrease in relative chance of remission (p < .0001). Following adjustments for betweengroup baseline differences, remission rates were no longer different. Conclusion: Melancholic features are associated with a significantly reduced remission rate with an SSRI. This effect appears to be accounted for by demographic and clinical features associated with melancholic features. Trial Registration: clinicaltrials.gov Identifier: NCT0021528.
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U2 - 10.4088/JCP.v69n1201
DO - 10.4088/JCP.v69n1201
M3 - Article
C2 - 19026268
AN - SCOPUS:60349112465
SN - 0160-6689
VL - 69
SP - 1847
EP - 1855
JO - Journal of Clinical Psychiatry
JF - Journal of Clinical Psychiatry
IS - 12
ER -