Frederikke Hordam Gronemann1, Martin Balslev Jorgensen2, Merete Nordentoft3, Per Kragh Andersen4, Merete Osler5. 1. Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospitals, Nordre Fasanvej 57, building 14, entrance 5, 2000 Frederiksberg, Denmark. Electronic address: frederikke.hoerdam@regionh.dk. 2. Mental Health Centre Copenhagen, Copenhagen, Denmark. 3. Mental Health Centre Copenhagen, Copenhagen, Denmark; Lundbeck Foundation Initiative for Integrative Psychiatric Research iPsych, Copenhagen and Aarhus, Denmark. 4. Department of Public Health, Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark. 5. Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospitals, Nordre Fasanvej 57, building 14, entrance 5, 2000 Frederiksberg, Denmark; Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark.
Abstract
BACKGROUND: Knowledge of risk factors of treatment-resistant depression (TRD) contributes to understand the underlying mechanisms and to identify patients at risk. However, there is still a lack of studies on how different risk factors associate with TRD. The objective of this study was to determine the independent association of several socio-demographic and clinical risk factors with TRD. METHODS: 194.074 patients with a first-time hospital contact for depression identified in the Danish National Patient Registry (DNPR) from 1996 through 2014 were followed for TRD for 12 months after diagnosis. Socio-demographic and clinical risk factors were identified in nation-wide registries. Data were analyzed using Cox Proportional Hazard Regression and Fine-Gray model for competing mortality risk. RESULTS: Indicators of disease severity (recurrent depression (adjusted HR (aHR) 1.17 (1.14-1.20)), severity of depression (aHR 2.01 (1.95-2.08)), admission to a psychiatric ward (aHR 2.03 (1.96, 2.10)) were strong risk factors. Aged 65-84 (aHR 1.96 (1.83-2.10)), lost labor market affiliation ((aHR 1.12 (1.08, 1.16)), cohabiting (aHR 1.27 (1.23, 1.30)), comorbid anxiety (aHR 1.18 (1.10-1.27)), insomnia (aHR 1.27 (1.06-1.51)), migraine (aHR 1.42 (1.16-1.73)) and use of psychotropic drugs was also associated with higher rates of TRD. LIMITATIONS: Information on drug use during hospitalization was not available. Information on rating scales could have provided a more precise assessment of symptom severity and treatment response. CONCLUSIONS: Besides indicators of disease severity, other important risk factors associated with TRD are age, lost labor market affiliation, cohabiting with a partner as well as anxiety, insomnia, migraine and the use of psychotropic medications.
BACKGROUND: Knowledge of risk factors of treatment-resistant depression (TRD) contributes to understand the underlying mechanisms and to identify patients at risk. However, there is still a lack of studies on how different risk factors associate with TRD. The objective of this study was to determine the independent association of several socio-demographic and clinical risk factors with TRD. METHODS: 194.074 patients with a first-time hospital contact for depression identified in the Danish National Patient Registry (DNPR) from 1996 through 2014 were followed for TRD for 12 months after diagnosis. Socio-demographic and clinical risk factors were identified in nation-wide registries. Data were analyzed using Cox Proportional Hazard Regression and Fine-Gray model for competing mortality risk. RESULTS: Indicators of disease severity (recurrent depression (adjusted HR (aHR) 1.17 (1.14-1.20)), severity of depression (aHR 2.01 (1.95-2.08)), admission to a psychiatric ward (aHR 2.03 (1.96, 2.10)) were strong risk factors. Aged 65-84 (aHR 1.96 (1.83-2.10)), lost labor market affiliation ((aHR 1.12 (1.08, 1.16)), cohabiting (aHR 1.27 (1.23, 1.30)), comorbid anxiety (aHR 1.18 (1.10-1.27)), insomnia (aHR 1.27 (1.06-1.51)), migraine (aHR 1.42 (1.16-1.73)) and use of psychotropic drugs was also associated with higher rates of TRD. LIMITATIONS: Information on drug use during hospitalization was not available. Information on rating scales could have provided a more precise assessment of symptom severity and treatment response. CONCLUSIONS: Besides indicators of disease severity, other important risk factors associated with TRD are age, lost labor market affiliation, cohabiting with a partner as well as anxiety, insomnia, migraine and the use of psychotropic medications.
Authors: Heidi Taipale; Johan Reutfors; Antti Tanskanen; Lena Brandt; Jari Tiihonen; Allitia DiBernardo; Ellenor Mittendorfer-Rutz; Philip Brenner Journal: BMC Psychiatry Date: 2020-05-13 Impact factor: 3.630
Authors: Péter Döme; Péter Kunovszki; Péter Takács; László Fehér; Tamás Balázs; Károly Dede; Siobhán Mulhern-Haughey; Sébastien Barbreau; Zoltán Rihmer Journal: PLoS One Date: 2021-01-20 Impact factor: 3.240
Authors: A John Rush; Harold A Sackeim; Charles R Conway; Mark T Bunker; Steven D Hollon; Koen Demyttenaere; Allan H Young; Scott T Aaronson; Maxine Dibué; Michael E Thase; R Hamish McAllister-Williams Journal: Psychol Med Date: 2022-01-07 Impact factor: 7.723