期刊
JOURNAL OF CLINICAL PSYCHOPHARMACOLOGY
卷 31, 期 2, 页码 180-186出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/JCP.0b013e31820ebd2c
关键词
depression; STAR*D; residual; symptoms; treatment response
资金
- National Institute of Mental Health [N01MH90003]
- National Institutes of Health
- National Center for Research Resources
- National Alliance for the Research of Schizophrenia and Depression
- Aspect Medical Systems/Covidien
- Cyberonics, Inc.
- Eli Lilly Company
- Neuronetics
- Novartis
- Sepracor
- National Institutes of Health, National Institute of Mental Health
- Stanley Medical Research Institute
- St. Jude Medical Center
- Brainsway
- Pfizer, Inc.
- Cephalor, Inc.
- Cederroth
- Cyberonics
- Forest
- Medtronics
- National Alliance for Research on Schizophrenia and Depression
- Ortho-McNeil-Janssen
- Pamlab
- Pfizer
- Shire
- Stanley Foundation through the Broad Institute
- Bristol-Myers Squibb
- Eli Lilly
- GlaxoSmithKline
- Janssen
- Lictwer Pharma
- Wyeth
- AstraZeneca
- Advanced Neuromodulation Systems
- Best Practice Project Management
- Bristol-Myers Squibb/Otsuka
- Gerson Lehrman Group
- Jazz Pharmaceuticals
- Magellan Health Services
- Merck Co.
- Novartis Pharmaceuticals
- Ono Pharmaceuticals
- Organon
- Otsuka Pharmaceuticals
- Transcept Pharmaceuticals
- Urban Institute
- Wyeth Ayerst
- University of Michigan
- Brain Resource
- Forest Pharmaceuticals
- Society of Biological Psychiatry
- Agency for Healthcare Research and Quality (AHRQ)
- Corcept Therapeutics, Inc.
- National Institute on Drug Abuse
- Pharmacia Upjohn
- Predix Pharmaceuticals (Epix)
- Solvay Pharmaceuticals, Inc.
- Targacept
- ImaRx Therapeutics, Inc.
- Case Western Reserve University
- Singapore Clinical Research Institute
- Dey Pharmaceuticals
- Venebio
- National Institute of Health, National Institute of Neurological Disorders and Stroke
- National Institute of Health, National Institute of Aging
Little is known about the quantity or quality of residual depressive symptoms in patients with major depressive disorder (MDD) who have responded but not remitted with antidepressant treatment. This report describes the residual symptom domains and individual depressive symptoms in a large representative sample of outpatients with nonpsychotic MDD who responded without remitting after up to 12 weeks of citalopram treatment in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study. Response was defined as 50% or greater reduction in baseline 16-item Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR16) by treatment exit, and remission as a final QIDS-SR16 of less than 6. Residual symptom domains and individual symptoms were based on the QIDS-SR16 and classified as either persisting from baseline or emerging during treatment. Most responders who did not remit endorsed approximately 5 residual symptom domains and 6 to 7 residual depressive symptoms. The most common domains were insomnia (94.6%), sad mood (70.8%), and decreased concentration (69.6%). The most common individual symptoms were midnocturnal insomnia (79.0%), sad mood (70.8%), and decreased concentration/decision making (69.6%). The most common treatment-emergent symptoms were midnocturnal insomnia (51.4%) and decreased general interest (40.0%). The most common persistent symptoms were midnocturnal insomnia (81.6%), sad mood (70.8%), and decreased concentration/decision making (70.6%). Suicidal ideation was the least common treatment-emergent symptom (0.7%) and the least common persistent residual symptom (17.1%). These findings suggest that depressed outpatients who respond by 50% without remitting to citalopram treatment have a broad range of residual symptoms. Individualized treatments are warranted to specifically address each patient's residual depressive symptoms.
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