Faculty Opinions recommendation of What happens to patients with treatment-resistant depression? A systematic review of medium to long term outcome studies.

2009 ◽  
Author(s):  
Mark George
Keyword(s):  
Systematic Review ◽  
Outcome Studies ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Resistant Depression

What happens to patients with treatment-resistant depression? A systematic review of medium to long term outcome studies

2009 ◽  
Vol 116 (1-2) ◽  
pp. 4-11 ◽  
Author(s):  
Abebaw Fekadu ◽  
Sarah C. Wooderson ◽  
Kalypso Markopoulo ◽  
Catherine Donaldson ◽  
Andrew Papadopoulos ◽  
...  
Keyword(s):  
Systematic Review ◽  
Outcome Studies ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Resistant Depression

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.

scholarly journals Long-Term Efficacy of Intranasal Esketamine in Treatment-Resistant Major Depression: A Systematic Review

2021 ◽  
Vol 22 (17) ◽  
pp. 9338
Author(s):  
Enrico Capuzzi ◽  
Alice Caldiroli ◽  
Martina Capellazzi ◽  
Ilaria Tagliabue ◽  
Matteo Marcatili ◽  
...  
Keyword(s):  
Systematic Review ◽  
High Risk ◽  
Relapse Prevention ◽  
Risk Of Bias ◽  
Induction Phase ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
Resistant Depression ◽  
Larger Sample

Esketamine (ESK) has been approved as a rapid-acting intranasal treatment for treatment-resistant depression (TRD). Although existing studies have investigated the efficacy of ESK in the 4-week induction phase, our knowledge about long-term ESK efficacy remains poor. The aim of this systematic review was to summarize the available data on long-term ESK efficacy for TRD. A systematic search was performed including articles in English, up to 31 March 2021. The search found 7 relevant studies, involving 1024 adult TRD patients. Continuing treatment with ESK after the 4-week induction phase may be associated with stable efficacy in relapse prevention among TRD patients. Conversely, the long-term antidepressant effectiveness upon discontinuation of ESK might be limited, although data from three studies had a moderate to high risk of bias. Overall, the results on the effectiveness of this compound in the long term are mixed. According to our findings, ESK treatment should be continued following the induction phase to reach a stable efficacy in relapse prevention, while the long-term antidepressant and anti-suicidal effects of ESK after discontinuation are inconsistent. Currently, the level of proof of ESK efficacy in long-term TRD treatment remains low and more RCTs with larger sample sizes and active comparators are needed.

ANOREXIA NERVOSA

PEDIATRICS ◽  
1982 ◽  
Vol 70 (4) ◽  
pp. 525-525
Author(s):  
Robert J. Haggerty
Keyword(s):  
Anorexia Nervosa ◽  
Early Onset ◽  
Age Of Onset ◽  
Outcome Studies ◽  
Psychosomatic Disorder ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Follow Up Studies

Anorexia nervosa is a serious psychosomatic disorder which most typically begins between 16 and 18 years of age. Clinicians have often held that early onset (eg, ages 11 to 15) is associated with a better outcome. This paper reviews the long-term outcome studies on anorexia nervosa and concludes that this contention is not supported by available data. The methodologies of seven outcome studies that focus on an early onset population are critiqued, and it is concluded that two methodologies are strong. Because of the increasing prevalence of anorexia nervosa, this once rare disorder can now be more easily investigated, and consequently better follow-up studies, which examine potential prognostic factors including age of onset, should be forthcoming.

scholarly journals Augmentation therapies for treatment-resistant depression: systematic review and meta-analysis – CORRIGENDUM

2018 ◽  
Vol 214 (5) ◽  
pp. 308-308
Author(s):  
Rebecca Strawbridge ◽  
Ben Carter ◽  
Lindsey Marwood ◽  
Borwin Bandelow ◽  
Dimosthenis Tsapekos ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
Resistant Depression

scholarly journals Deep Brain Stimulation for Treatment-resistant Depression: Systematic Review of Clinical Outcomes

2014 ◽  
Vol 11 (3) ◽  
pp. 475-484 ◽  
Author(s):  
Takashi Morishita ◽  
Sarah M. Fayad ◽  
Masa-aki Higuchi ◽  
Kelsey A. Nestor ◽  
Kelly D. Foote
Keyword(s):  
Systematic Review ◽  
Deep Brain Stimulation ◽  
Clinical Outcomes ◽  
Brain Stimulation ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
Resistant Depression ◽  
Deep Brain

scholarly journals Placebo response in treatment resistant depression: a systematic review and meta-analysis of multiple treatment modalities

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S261-S262
Author(s):  
Brett D M Jones ◽  
Cory R. Weissman ◽  
Jewel Karbi ◽  
Tya Vine ◽  
Louise S. Mulsant ◽  
...  
Keyword(s):  
Systematic Review ◽  
Brain Stimulation ◽  
Placebo Effect ◽  
Meta Analysis ◽  
Specific Treatment ◽  
Placebo Response ◽  
Treatment Modalities ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
Resistant Depression

AimsThe placebo response in depression clinical trials is a major contributing factor for failure to establish the efficacy of novel and repurposed treatments. However, it is not clear as to what the placebo response in treatment-resistant depression (TRD) patients is or whether it differs across treatment modalities. Our objective was to conduct a systematic review and meta-analysis of the magnitude of the placebo response in TRD patients across different treatment modalities and its possible moderators.MethodSearches were conducted on MEDLINE and PsychInfo from inception to January 24, 2020. Only studies that recruited TRD patients and randomization to a placebo (or sham) arm in a pharmacotherapy, brain stimulation, or psychotherapy study were included (PROSPERO 2020 CRD42020190465). The primary outcome was the Hedges’ g for the reported depression scale using a random-effects model. Secondary outcomes included moderators assessed via meta-regression and response and remission rate. Heterogeneity was evaluated using the Egger's Test and a funnel plot. Cochrane Risk of Bias Tool was used to estimate risks.Result46 studies met our inclusion criteria involving a total of 3083 participants (mean (SD) age: 45.7 (6.2); female: 52.4%). The pooled placebo effect for all modalities was large (N = 3083, g = 1.08 ,95% CI [0.95-1.20)I 2 = 0.1). The placebo effect in studies of specific treatment modalities did not significantly differ: oral medications g = 1.14 (95%CI:0.99-1.29); parenteral medications g = 1.32 (95%CI:0.59-2.04); ayahuasca g = 0.47 (95%CI:-0.28-1.17); rTMS g = 0.93 (95%CI:0.63-1.23); tDCS g = 1.32 (95%CI:0.52-2.11); invasive brain stimulation g = 1.06 (95%CI:0.64-1.47). There were no psychotherapy trials that met our eligibility criteria. Similarly, response and remission rates were comparable across modalities. Heterogeneity was large. Two variables predicted a lager placebo effect: open-label prospective design (B:0.32, 95%CI: 0.05-0.58; p:0.02) and sponsoring by a pharmaceutical or medical device company (B:0.39, 95%CI:0.13-0.65, p:0.004)). No risk of publication bias was found.ConclusionThe overall placebo effect in TRD studies was large (g = 1.08) and did not differ among treatment modalities. A better understanding of the placebo response in TRD will require: standardizing the definition of TRD, head-to-head comparisons of treatment modalities, an assessment of patient expectations and experiences, and standardized reporting of outcomes.

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