BackgroundTreatment-resistant depression (TRD) is an important clinical challenge and may present differently between age groups. MethodsA total of 893 depressed patients recruited within the framework of the European research consortium "Group for the Studies of Resistant Depression" were assessed by generalized linear models regarding age effects (both as numerical and factorial predictors) on treatment outcome, number of lifetime depressive episodes, hospitalization time, and duration of the current episode. Effects of age as numerical predictor on the severity of common depressive symptoms, measured with Montgomery-angstrom sberg Depression Rating Scale (MADRS) for two-time points, were assessed by linear mixed models, respectively, for patients showing TRD and treatment response. A corrected p threshold of 0.001 was applied. ResultsOverall symptom load reflected by MADRS (p < 0.0001) and lifetime hospitalization time (p < 0.0001) increased with age in TRD patients but not treatment responders. In TRD, higher age was predicting symptom severity of inner tension, reduced appetite, concentrations difficulties, and lassitude (all p <= 0.001). Regarding clinical significance, older TRD patients were more likely to report severe symptoms (item score > 4) for these items both before and after treatment (all p <= 0.001). ConclusionsIn this naturalistic sample of severely ill depressed patients, antidepressant treatment protocols were equally effective in addressing TRD in old age. However, specific symptoms such as sadness, appetite, and concentration showed an age-dependent presentation, impacting residual symptoms in severely affected TRD patients and calling for a precision approach by a better integration of age profiles in treatment recommendations.

Age as a moderating factor of treatment resistance in depression / Kautzky, Alexander; Bartova, Lucie; Fugger, Gernot; Dold, Markus; Souery, Daniel; Montgomery, Stuart; Zohar, Joseph; Mendlewicz, Julien; Fabbri, Chiara; Serretti, Alessandro; Rujescu, Dan; Kasper, Siegfried. - In: EUROPEAN PSYCHIATRY. - ISSN 1778-3585. - ELETTRONICO. - 66:1(2023), pp. e35.1-e35.9. [10.1192/j.eurpsy.2023.17]

Age as a moderating factor of treatment resistance in depression

Fabbri, Chiara;Serretti, Alessandro;
2023

Abstract

BackgroundTreatment-resistant depression (TRD) is an important clinical challenge and may present differently between age groups. MethodsA total of 893 depressed patients recruited within the framework of the European research consortium "Group for the Studies of Resistant Depression" were assessed by generalized linear models regarding age effects (both as numerical and factorial predictors) on treatment outcome, number of lifetime depressive episodes, hospitalization time, and duration of the current episode. Effects of age as numerical predictor on the severity of common depressive symptoms, measured with Montgomery-angstrom sberg Depression Rating Scale (MADRS) for two-time points, were assessed by linear mixed models, respectively, for patients showing TRD and treatment response. A corrected p threshold of 0.001 was applied. ResultsOverall symptom load reflected by MADRS (p < 0.0001) and lifetime hospitalization time (p < 0.0001) increased with age in TRD patients but not treatment responders. In TRD, higher age was predicting symptom severity of inner tension, reduced appetite, concentrations difficulties, and lassitude (all p <= 0.001). Regarding clinical significance, older TRD patients were more likely to report severe symptoms (item score > 4) for these items both before and after treatment (all p <= 0.001). ConclusionsIn this naturalistic sample of severely ill depressed patients, antidepressant treatment protocols were equally effective in addressing TRD in old age. However, specific symptoms such as sadness, appetite, and concentration showed an age-dependent presentation, impacting residual symptoms in severely affected TRD patients and calling for a precision approach by a better integration of age profiles in treatment recommendations.
2023
Age as a moderating factor of treatment resistance in depression / Kautzky, Alexander; Bartova, Lucie; Fugger, Gernot; Dold, Markus; Souery, Daniel; Montgomery, Stuart; Zohar, Joseph; Mendlewicz, Julien; Fabbri, Chiara; Serretti, Alessandro; Rujescu, Dan; Kasper, Siegfried. - In: EUROPEAN PSYCHIATRY. - ISSN 1778-3585. - ELETTRONICO. - 66:1(2023), pp. e35.1-e35.9. [10.1192/j.eurpsy.2023.17]
Kautzky, Alexander; Bartova, Lucie; Fugger, Gernot; Dold, Markus; Souery, Daniel; Montgomery, Stuart; Zohar, Joseph; Mendlewicz, Julien; Fabbri, Chiara; Serretti, Alessandro; Rujescu, Dan; Kasper, Siegfried
File in questo prodotto:
File Dimensione Formato  
age-as-a-moderating-factor-of-treatment-resistance-in-depression.pdf

accesso aperto

Tipo: Versione (PDF) editoriale
Licenza: Licenza per Accesso Aperto. Creative Commons Attribuzione (CCBY)
Dimensione 864.43 kB
Formato Adobe PDF
864.43 kB Adobe PDF Visualizza/Apri
S0924933823000172sup001.docx

accesso aperto

Tipo: File Supplementare
Licenza: Licenza per Accesso Aperto. Creative Commons Attribuzione (CCBY)
Dimensione 12.43 MB
Formato Microsoft Word XML
12.43 MB Microsoft Word XML Visualizza/Apri

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/955081
Citazioni
  • ???jsp.display-item.citation.pmc??? 0
  • Scopus 2
  • ???jsp.display-item.citation.isi??? 1
social impact