Childhood maltreatment and clinical severity of treatment‐resistant depression in a French cohort of outpatients (FACE‐DR): One‐year follow‐up

2020 ◽  
Vol 37 (4) ◽  
pp. 365-374 ◽  
Author(s):  
Antoine Yrondi ◽  
Bruno Aouizerate ◽  
Djamila Bennabi ◽  
Raphaëlle Richieri ◽  
Thierry D'Amato ◽  
...  
Keyword(s):  
Childhood Maltreatment ◽  
Clinical Severity ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
Resistant Depression ◽  
One Year ◽  
French Cohort

scholarly journals Epidemiology and current treatment patterns of treatment-resistant depression in Scotland: a CPRD study

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S334-S334
Author(s):  
Timothy Ming ◽  
Tom Denee ◽  
Gemma Scott ◽  
Joachim Morrens ◽  
Christopher Weatherburn
Keyword(s):  
Clinical Practice ◽  
Incidence Rates ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Treatment Resistant Depression ◽  
Augmentation Therapy ◽  
Treatment Resistant ◽  
First Line ◽  
Resistant Depression

AimsTo assess the incidence and treatments currently used in clinical practice for the treatment of treatment-resistant depression (TRD) in Scotland.BackgroundPatients with major depressive disorder (MDD) who have not responded to at least two successive antidepressant (AD) treatments in a single episode are described as having Treatment-Resistant Depression (TRD). Epidemiological data on TRD in Scotland is lacking. Furthermore, there is no data to our knowledge on therapies prescribed in Scottish clinical practice to treat TRD.MethodA retrospective, longitudinal cohort study was conducted using Clinical Practice Research Datalink (CPRD) medical records. Adult patients were indexed on AD prescription, requiring MDD diagnosis within 90 days, from Jan 2011-May 2018 with 360-day baseline and 180-day minimum follow-up periods. Failure of ≥2 adequate oral AD regimens following indexing constituted TRD classification. Incidence rates of MDD and TRD (within the MDD cohort) and treatment lines following TRD classification were derived.ResultThe analysis included 20,059 patients with MDD (mean age 44 years, 63% female, median follow-up 59 months); 1,374 (6.8%) were classified as TRD. Median time-to-TRD classification was 25 months. The incidence rate of MDD was 15.9 per 1,000 patient-years and for TRD was 14.7 per 1,000 MDD-patient-years. For all first four post-TRD treatment lines, SSRI monotherapy was the most commonly prescribed therapy, followed by combination (dual/triple) therapy and augmentation therapy (at least one oral AD supplemented with lithium, an antipsychotic or an anticonvulsant therapy). At first-line of TRD treatment, 1,050 (76.4%) patients received monotherapy AD, 212 (15.4%) received combination AD therapy and 112 (8.2%) received augmentation therapy. The most common monotherapy treatments at first-line TRD were sertraline (15.6%), mirtazapine (13.8%), fluoxetine (12.2%) and venlafaxine (11.6%). Among combination therapies, mirtazapine, venlafaxine, sertraline and amitriptyline were frequently used. Among the TRD and MDD cohort, no somatic treatments were coded in CPRD, although the use of these treatments was likely underestimated.ConclusionMonotherapy AD treatment was the most common therapy type for all four post-TRD treatment lines. These data support the need for new treatments that can achieve and maintain therapeutic response, and avoid continuous cycling through similar AD therapies.This study was sponsored by Janssen Cilag Ltd.

scholarly journals Prediction of longer-term outcome of treatment-resistant depression in tertiary care

2012 ◽  
Vol 201 (5) ◽  
pp. 369-375 ◽  
Author(s):  
Abebaw Fekadu ◽  
Lena J. Rane ◽  
Sarah C. Wooderson ◽  
Kalypso Markopoulou ◽  
Lucia Poon ◽  
...  
Keyword(s):  
Social Support ◽  
Tertiary Care ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Early Relapse ◽  
Full Remission ◽  
Resistant Depression

BackgroundSystematic studies on the outcome of treatment-resistant depression are scarce.AimsTo describe the longer-term outcome and predictors of outcome in treatment-resistant depression.MethodOut of 150 patients approached, 118 participants with confirmed treatment-resistant depression (unipolar, n= 7; bipolar, n=27; secondary, n=14) treated in a specialist in-patient centre were followed-up for between 8 and 84 months (mean=39, s.d.=22).ResultsThe majority of participants attained full remission (60.2%), most of whom (48.3% of total sample) showed sustained recovery (full remission for at least 6 months). A substantial minority had persistent subsyndromal depression (19.5%) or persistent depressive episode (20.3%). Diagnosis of bipolar treatment-resistant depression and poorer social support were associated with early relapse, whereas strong social support, higher educational status and milder level of treatment resistance measured with the Maudsley Staging Method were associated with achieving quicker remission. Exploratory analysis of treatment found positive associations between treatment with a monoamine oxidase inhibitor (MAOl) in unipolar treatment-resistant depression and attaining remission at discharge and at final follow-up, and duloxetine use predicted attainment of remission at final follow-up.ConclusionsAlthough many patients with treatment-resistant depression experience persistent symptomatology even after intensive, specialist treatment, most can achieve remission. The choice of treatment and presence of good social support may affect remission rates, whereas those with low social support and a bipolar diathesis should be considered at higher risk of early relapse. We suggest that future work to improve the long-term outcome in this disabling form of depression might focus on social interventions to improve support, and the role of neglected pharmacological interventions such as MAOIs.

Deep Brain Stimulation for Treatment-Resistant Depression: Follow-Up After 3 to 6 Years

2011 ◽  
Vol 168 (5) ◽  
pp. 502-510 ◽  
Author(s):  
Sidney H. Kennedy ◽  
Peter Giacobbe ◽  
Sakina J. Rizvi ◽  
Franca M. Placenza ◽  
Yasunori Nishikawa ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
Resistant Depression ◽  
Deep Brain

Rumination-focused cognitive behaviour therapy for non-responsive chronic depression: an uncontrolled group study

2019 ◽  
Vol 48 (3) ◽  
pp. 376-381
Author(s):  
Stine Bjerrum Moeller ◽  
Stephen F. Austin ◽  
Morten Hvenegaard ◽  
Morten Kistrup ◽  
Stine Gran ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Small Sample ◽  
Post Treatment ◽  
Chronic Depression ◽  
Hamilton Depression Scale ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
Cognitive Behaviour ◽  
Resistant Depression

AbstractBackground:One-third of patients with depression do not respond satisfactorily to treatment, and approximately 20% of all patients treated for depression develop a chronic depression. One approach to more effective treatment of chronic and treatment-resistant depression is to target rumination – an underlying mechanism implicated in the development and maintenance of depression.Aim:The purpose of this uncontrolled group study was to investigate the feasibility of individual rumination-focused cognitive behavioural therapy (RfCBT) for patients with chronic and treatment-resistant depression.Method:A total of 10 patients with chronic and treatment-resistant depression were offered 12–16 individual sessions of RfCBT. The primary outcome was depressive symptoms as measured by Hamilton Depression Scale at pre-, post- and 3-month follow-up. Secondary symptoms measured included self-reported rumination and worry.Results:There was a significant reduction in depressive symptoms (p < 0.05), rumination (p < 0.01) and worry (p < 0.5) from pre- to post-treatment. Half of the participants (n = 5) showed significant reliable change on levels of depressive symptoms post-treatment. The reduction in depressive symptoms, rumination and worry were maintained at follow-up.Conclusions:RfCBT was associated with significant reductions in depressive symptoms in a small sample with chronic and treatment-resistant depression. Despite limitations of being a small uncontrolled study with limited follow-up, these results are promising in a difficult to treat population. RfCBT warrants further systematic evaluation.

Five-Year Follow-Up of Bilateral Epidural Prefrontal Cortical Stimulation for Treatment-Resistant Depression

2016 ◽  
Vol 9 (6) ◽  
pp. 897-904 ◽  
Author(s):  
Nolan R. Williams ◽  
E. Baron Short ◽  
Thomas Hopkins ◽  
Brandon S. Bentzley ◽  
Greg L. Sahlem ◽  
...  
Keyword(s):  
Cortical Stimulation ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
Prefrontal Cortical ◽  
Resistant Depression
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