What moderator characteristics are associated with better prognosis for depression?

Madhukar H Trivedi¹, David W Morris¹, Ji-Yang Pan², Bruce D Grannemann¹, A John Rush¹

¹Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA; ²Department of Psychiatry, Third Hospital of Sun Yat-Sen University of Medical Sciences, Shipai, Guangshou, Peoples Republic of China

Abstract: A retrospective data analysis was conducted to evaluate the usefulness of baseline characteristics in predicting treatment response to antidepressant medication in 97 outpatients with nonpsychotic major depression treated for up to sixteen weeks with nefazodone. Baseline demographics (gender), illness features (symptom severity, length of illness, length of current episode, number of episodes, age of onset, longitudinal subtype, endogenicity, melancholia, family history of mood disorders), and social features (living status) were evaluated. Response to treatment was defined as a ≥ 50% reduction in the 17-item Hamilton Rating Scale for Depression (HRSD17) score. The results of a survival analysis indicated that patients with shorter histories of illness (< 4 years), a negative family history of depression, and those who were either married or were living with someone were more likely to have a positive outcome during the acute phase treatment of depression. The main findings are consistent with extensive previous literature indicating a better short-term outcome of depression where illness is shorter, where there is no family history, and where there is better social support.

Keywords: antidepressant, treatment predictor, social support, major depression