Literature DB >> 23489398

Differential impact of isolated psychotic symptoms on treatment outcome of major depressive disorder in the STAR*D cohort of Whites, Blacks and Latinos.

Paolo Cassano1, Trina Chang, Nhi-Ha Trinh, Lee Baer, Maurizio Fava, David Mischoulon.   

Abstract

OBJECTIVE: To determine whether isolated psychotic symptoms are more likely to be endorsed by depressed Latinos as opposed to other ethnic-racial groups; whether these symptoms affect Latinos similarly to other ethnic-racial groups in terms of treatment response; and whether they are more likely to be associated with anxiety disorders in depressed Latinos.
METHODS: We analyzed data from STAR*D subjects who self identified as White, Black, or Latino. Rates of isolated psychotic symptoms were assessed by the self-rated Psychiatric Diagnostic Screening Questionnaire (PDSQ) and compared between ethnic-racial groups. Depressive remission outcomes were compared within each ethnic-racial group between subjects who endorsed psychotic symptoms versus no psychotic symptoms. Associations between isolated psychotic symptoms and anxiety disorders were also examined.
RESULTS: Among 2597 eligible subjects with at least one post-baseline assessment and available PDSQ data excluding first-rank symptoms, the prevalence of auditory-visual hallucination was 2.5% in Whites (n=49/1928), 11.3% in Blacks (n=45/398) 6.3% in Latinos (n=17/270) (χ(2)=64.9; df=2; p<0.001). Prevalence of paranoid ideation was 15.5% in Whites (n=299/1927), 31.5% in Blacks (n=126/400), and 21.1% in Latinos (n=57/270) (χ(2)=57.3; df=2; p<0.001). Among Whites and Blacks but not Latinos, depressive remission rates were worse in subjects with auditory-visual hallucinations compared to those without them. Paranoid ideation had a significant negative impact on remission in Whites only. In all ethnic-racial groups, a significant association was found between auditory-visual hallucinations and PTSD and panic disorder. LIMITATIONS: The STAR*D study did not include any structured clinician-based assessment of psychotic symptoms.
CONCLUSION: Latinos do not appear to have worse outcomes when treated for MDD with auditory-visual hallucinations, differently from Whites and Blacks.
Copyright © 2013 Elsevier B.V. All rights reserved.

Entities:  

Keywords:  Antidepressants; Hispanic; Latinos; Major depressive disorder; Psychosis-like symptoms; Remission

Mesh:

Year:  2013        PMID: 23489398      PMCID: PMC3749257          DOI: 10.1016/j.jad.2013.02.012

Source DB:  PubMed          Journal:  J Affect Disord        ISSN: 0165-0327            Impact factor:   4.839


  22 in total

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