Trajectories of individual symptoms in remitters versus non-remitters with depression

Hitoshi Sakurai, Hiroyuki Uchida, Takayuki Abe, Shinichiro Nakajima, Takefumi Suzuki, Bruce G. Pollock, Yuji Sato, Masaru Mimura

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Background It remains unclear regarding the contribution of each individual symptom in predicting the outcome in major depressive disorder (MDD). The objective of this analysis was to evaluate trajectories of individual symptoms over time to identify which specific depressive item(s) could predict subsequent clinical response. Methods The data of 2874 outpatients with nonpsychotic MDD who received citalopram for up to 14 weeks in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial were analyzed. Average trajectories of individual symptoms over time were estimated for remitters and non-remitters. Moreover, specific symptoms whose improvement at week 2 predicted remission were identified, using binary logistic regression analysis. Results Trajectories were significantly different between remitters and non-remitters in all depressive symptoms. All depressive symptoms in the 16-item Quick Inventory of Depressive Symptomatology, Self-Report (QIDS-SR16) in the two groups, except for hypersomnia and weight change in non-remitters, substantially improved within 2 weeks and gradually continued to improve thereafter throughout the 14 weeks. Early improvements in the following five symptoms, in order of magnitude, in the QIDS-SR16 were significantly associated with remission: sad mood, negative self-view, feeling slowed down, low energy, and restlessness (P<0.001, P<0.001, P=0.001, P=0.004, P=0.021). Limitations The participants were limited to the nonpsychotic MDD outpatients who received citalopram. Further, symptomatology was not evaluated at the very beginning of treatment. Conclusions While the data pertain to citalopram and replication is necessary for other antidepressants, early improvements in certain core depressive symptoms may serve as a predictor of subsequent remission.

Original languageEnglish
Pages (from-to)506-513
Number of pages8
JournalJournal of Affective Disorders
Volume151
Issue number2
DOIs
Publication statusPublished - 2013 Nov

Fingerprint

Citalopram
Major Depressive Disorder
Depression
Outpatients
Disorders of Excessive Somnolence
Psychomotor Agitation
Self Report
Antidepressive Agents
Emotions
Logistic Models
Regression Analysis
Weights and Measures
Equipment and Supplies
Therapeutics

Keywords

  • Depression
  • Major depressive disorder
  • Prediction
  • Remission

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology

Cite this

Trajectories of individual symptoms in remitters versus non-remitters with depression. / Sakurai, Hitoshi; Uchida, Hiroyuki; Abe, Takayuki; Nakajima, Shinichiro; Suzuki, Takefumi; Pollock, Bruce G.; Sato, Yuji; Mimura, Masaru.

In: Journal of Affective Disorders, Vol. 151, No. 2, 11.2013, p. 506-513.

Research output: Contribution to journalArticle

Sakurai, Hitoshi ; Uchida, Hiroyuki ; Abe, Takayuki ; Nakajima, Shinichiro ; Suzuki, Takefumi ; Pollock, Bruce G. ; Sato, Yuji ; Mimura, Masaru. / Trajectories of individual symptoms in remitters versus non-remitters with depression. In: Journal of Affective Disorders. 2013 ; Vol. 151, No. 2. pp. 506-513.
@article{0eae384a661040178f59dda6ff85c1ff,
title = "Trajectories of individual symptoms in remitters versus non-remitters with depression",
abstract = "Background It remains unclear regarding the contribution of each individual symptom in predicting the outcome in major depressive disorder (MDD). The objective of this analysis was to evaluate trajectories of individual symptoms over time to identify which specific depressive item(s) could predict subsequent clinical response. Methods The data of 2874 outpatients with nonpsychotic MDD who received citalopram for up to 14 weeks in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial were analyzed. Average trajectories of individual symptoms over time were estimated for remitters and non-remitters. Moreover, specific symptoms whose improvement at week 2 predicted remission were identified, using binary logistic regression analysis. Results Trajectories were significantly different between remitters and non-remitters in all depressive symptoms. All depressive symptoms in the 16-item Quick Inventory of Depressive Symptomatology, Self-Report (QIDS-SR16) in the two groups, except for hypersomnia and weight change in non-remitters, substantially improved within 2 weeks and gradually continued to improve thereafter throughout the 14 weeks. Early improvements in the following five symptoms, in order of magnitude, in the QIDS-SR16 were significantly associated with remission: sad mood, negative self-view, feeling slowed down, low energy, and restlessness (P<0.001, P<0.001, P=0.001, P=0.004, P=0.021). Limitations The participants were limited to the nonpsychotic MDD outpatients who received citalopram. Further, symptomatology was not evaluated at the very beginning of treatment. Conclusions While the data pertain to citalopram and replication is necessary for other antidepressants, early improvements in certain core depressive symptoms may serve as a predictor of subsequent remission.",
keywords = "Depression, Major depressive disorder, Prediction, Remission",
author = "Hitoshi Sakurai and Hiroyuki Uchida and Takayuki Abe and Shinichiro Nakajima and Takefumi Suzuki and Pollock, {Bruce G.} and Yuji Sato and Masaru Mimura",
year = "2013",
month = "11",
doi = "10.1016/j.jad.2013.06.035",
language = "English",
volume = "151",
pages = "506--513",
journal = "Journal of Affective Disorders",
issn = "0165-0327",
publisher = "Elsevier",
number = "2",

}

TY - JOUR

T1 - Trajectories of individual symptoms in remitters versus non-remitters with depression

AU - Sakurai, Hitoshi

AU - Uchida, Hiroyuki

AU - Abe, Takayuki

AU - Nakajima, Shinichiro

AU - Suzuki, Takefumi

AU - Pollock, Bruce G.

AU - Sato, Yuji

AU - Mimura, Masaru

PY - 2013/11

Y1 - 2013/11

N2 - Background It remains unclear regarding the contribution of each individual symptom in predicting the outcome in major depressive disorder (MDD). The objective of this analysis was to evaluate trajectories of individual symptoms over time to identify which specific depressive item(s) could predict subsequent clinical response. Methods The data of 2874 outpatients with nonpsychotic MDD who received citalopram for up to 14 weeks in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial were analyzed. Average trajectories of individual symptoms over time were estimated for remitters and non-remitters. Moreover, specific symptoms whose improvement at week 2 predicted remission were identified, using binary logistic regression analysis. Results Trajectories were significantly different between remitters and non-remitters in all depressive symptoms. All depressive symptoms in the 16-item Quick Inventory of Depressive Symptomatology, Self-Report (QIDS-SR16) in the two groups, except for hypersomnia and weight change in non-remitters, substantially improved within 2 weeks and gradually continued to improve thereafter throughout the 14 weeks. Early improvements in the following five symptoms, in order of magnitude, in the QIDS-SR16 were significantly associated with remission: sad mood, negative self-view, feeling slowed down, low energy, and restlessness (P<0.001, P<0.001, P=0.001, P=0.004, P=0.021). Limitations The participants were limited to the nonpsychotic MDD outpatients who received citalopram. Further, symptomatology was not evaluated at the very beginning of treatment. Conclusions While the data pertain to citalopram and replication is necessary for other antidepressants, early improvements in certain core depressive symptoms may serve as a predictor of subsequent remission.

AB - Background It remains unclear regarding the contribution of each individual symptom in predicting the outcome in major depressive disorder (MDD). The objective of this analysis was to evaluate trajectories of individual symptoms over time to identify which specific depressive item(s) could predict subsequent clinical response. Methods The data of 2874 outpatients with nonpsychotic MDD who received citalopram for up to 14 weeks in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial were analyzed. Average trajectories of individual symptoms over time were estimated for remitters and non-remitters. Moreover, specific symptoms whose improvement at week 2 predicted remission were identified, using binary logistic regression analysis. Results Trajectories were significantly different between remitters and non-remitters in all depressive symptoms. All depressive symptoms in the 16-item Quick Inventory of Depressive Symptomatology, Self-Report (QIDS-SR16) in the two groups, except for hypersomnia and weight change in non-remitters, substantially improved within 2 weeks and gradually continued to improve thereafter throughout the 14 weeks. Early improvements in the following five symptoms, in order of magnitude, in the QIDS-SR16 were significantly associated with remission: sad mood, negative self-view, feeling slowed down, low energy, and restlessness (P<0.001, P<0.001, P=0.001, P=0.004, P=0.021). Limitations The participants were limited to the nonpsychotic MDD outpatients who received citalopram. Further, symptomatology was not evaluated at the very beginning of treatment. Conclusions While the data pertain to citalopram and replication is necessary for other antidepressants, early improvements in certain core depressive symptoms may serve as a predictor of subsequent remission.

KW - Depression

KW - Major depressive disorder

KW - Prediction

KW - Remission

UR - http://www.scopus.com/inward/record.url?scp=84885474874&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84885474874&partnerID=8YFLogxK

U2 - 10.1016/j.jad.2013.06.035

DO - 10.1016/j.jad.2013.06.035

M3 - Article

C2 - 23886402

AN - SCOPUS:84885474874

VL - 151

SP - 506

EP - 513

JO - Journal of Affective Disorders

JF - Journal of Affective Disorders

SN - 0165-0327

IS - 2

ER -