Bret R Rutherford1, C Jean Choi2, Jongwoo Choi2, Ben Mass3, Xiaofu He2, Kaleigh O'Boyle2, Joel Sneed4, Patrick J Brown3, Adam Brickman3, Melanie M Wall3, Steven P Roose3. 1. Columbia University Vagelos College of Physicians and Surgeons (BRR, BM, PJB, AB, MMW, SPR), New York State Psychiatric Institute, New York, NY. Electronic address: brr8@cumc.columbia.edu. 2. New York State Psychiatric Institute (CJC, JC XH, KB), New York, NY. 3. Columbia University Vagelos College of Physicians and Surgeons (BRR, BM, PJB, AB, MMW, SPR), New York State Psychiatric Institute, New York, NY. 4. Queens College of the City University of New York (JS), New York, NY.
Abstract
OBJECTIVE: Slowed processing speed and executive dysfunction are associated with poor outcomes in Late Life Depression (LLD), though it is unclear why. We investigated whether these variables interfere with the development of positive treatment expectancies in an antidepressant trial. METHODS: Depressed older subjects were randomized to Open (intended to increase patient expectancy) or Placebo-controlled (termed 'Hidden,' intended to decrease expectancy) administration of antidepressant medication for 8 weeks. Analysis of covariance analyzed the between-group difference on expectancy (Credibility and Expectancy Scale [CES]) and depression (Hamilton Rating Scale for Depression [HRSD], Clinical Global Impressions [CGI] Severity). Moderator analyses examined whether these Open versus Hidden differences varied based on higher versus lower processing speed and executive function. RESULTS: Among the 108 participants, a significant between-group difference was observed on expectancy (effect size [ES, Cohen's d] = 0.51 on CES Item 2; ES = 0.64 on Item 4), indicating the manipulation was effective. Processing speed as measured by the Stroop Color-Word Test (number color-words named in congruent condition) was a significant moderator of the Open versus Hidden effect on expectancy. Depressive symptom improvement was greater on average for Open versus Hidden participants who received active drug (CGI-severity ES = 1.25, HRSD ES = 0.41), but no neurocognitive moderators of the between-group difference reached statistical significance. CONCLUSIONS: Slowed processing speed impairs the development of expectancies in antidepressant trials for LLD, which may help explain lower antidepressant response among older adults. Future studies may address whether interventions to optimize treatment expectancies are capable of improving treatment outcomes.
OBJECTIVE: Slowed processing speed and executive dysfunction are associated with poor outcomes in Late Life Depression (LLD), though it is unclear why. We investigated whether these variables interfere with the development of positive treatment expectancies in an antidepressant trial. METHODS: Depressed older subjects were randomized to Open (intended to increase patient expectancy) or Placebo-controlled (termed 'Hidden,' intended to decrease expectancy) administration of antidepressant medication for 8 weeks. Analysis of covariance analyzed the between-group difference on expectancy (Credibility and Expectancy Scale [CES]) and depression (Hamilton Rating Scale for Depression [HRSD], Clinical Global Impressions [CGI] Severity). Moderator analyses examined whether these Open versus Hidden differences varied based on higher versus lower processing speed and executive function. RESULTS: Among the 108 participants, a significant between-group difference was observed on expectancy (effect size [ES, Cohen's d] = 0.51 on CES Item 2; ES = 0.64 on Item 4), indicating the manipulation was effective. Processing speed as measured by the Stroop Color-Word Test (number color-words named in congruent condition) was a significant moderator of the Open versus Hidden effect on expectancy. Depressive symptom improvement was greater on average for Open versus Hidden participants who received active drug (CGI-severity ES = 1.25, HRSD ES = 0.41), but no neurocognitive moderators of the between-group difference reached statistical significance. CONCLUSIONS: Slowed processing speed impairs the development of expectancies in antidepressant trials for LLD, which may help explain lower antidepressant response among older adults. Future studies may address whether interventions to optimize treatment expectancies are capable of improving treatment outcomes.
Authors: Marta Peciña; Amy S B Bohnert; Magdalena Sikora; Erich T Avery; Scott A Langenecker; Brian J Mickey; Jon-Kar Zubieta Journal: JAMA Psychiatry Date: 2015-11 Impact factor: 21.596
Authors: Monique A Pimontel; David Rindskopf; Bret R Rutherford; Patrick J Brown; Steven P Roose; Joel R Sneed Journal: Am J Geriatr Psychiatry Date: 2015-05-21 Impact factor: 4.105
Authors: Joel R Sneed; Bret R Rutherford; David Rindskopf; David T Lane; Harold A Sackeim; Steven P Roose Journal: Am J Geriatr Psychiatry Date: 2007-11-12 Impact factor: 4.105
Authors: Bret R Rutherford; Melanie M Wall; Patrick J Brown; Tse-Hwei Choo; Tor D Wager; Bradley S Peterson; Sarah Chung; Irving Kirsch; Steven P Roose Journal: Am J Psychiatry Date: 2016-09-09 Impact factor: 18.112
Authors: Meryl A Butters; Ellen M Whyte; Robert D Nebes; Amy E Begley; Mary Amanda Dew; Benoit H Mulsant; Michelle D Zmuda; Rishi Bhalla; Carolyn Cidis Meltzer; Bruce G Pollock; Charles F Reynolds; James T Becker Journal: Arch Gen Psychiatry Date: 2004-06
Authors: C Anacker; P A Zunszain; A Cattaneo; L A Carvalho; M J Garabedian; S Thuret; J Price; C M Pariante Journal: Mol Psychiatry Date: 2011-04-12 Impact factor: 15.992
Authors: Xiaofu He; Elena Pueraro; Yoojean Kim; Carolina Montes Garcia; Ben Maas; Jongwoo Choi; Dakota A Egglefield; Sophie Schiff; Joel R Sneed; Patrick J Brown; Adam M Brickman; Steven P Roose; Bret R Rutherford Journal: Am J Geriatr Psychiatry Date: 2021-01-23 Impact factor: 4.105
Authors: Sigal Zilcha-Mano; Meredith L Wallace; Patrick J Brown; Joel Sneed; Steven P Roose; Bret R Rutherford Journal: Transl Psychiatry Date: 2021-09-15 Impact factor: 7.989