Treatment-resistant depression episodes tied to more psychiatric comorbid conditions, health care utilization, self-harm, and all-cause mortality<\/p>\n<\/h3>\n
By Lori Solomon HealthDay Reporter<\/b><\/p>\n
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THURSDAY, Dec. 22, 2022 (HealthDay News) — Treatment-resistant depression (TRD) is associated with a heavy individual and societal burden, according to a study published online Dec. 14 in JAMA Psychiatry<\/em>.<\/p>\n Johan Lundberg, M.D., Ph.D., from the Karolinska Institutet in Stockholm, and colleagues estimated the burden of TRD in a large population covered by universal health care. Analysis included psychiatric and nonpsychiatric data from the Stockholm Major Depressive Disorder Cohort (2010 to 2017; including 158,169 unipolar MDD episodes in 145,577 patients) using the predefined criteria for TRD of three or more consecutive antidepressant treatments.<\/p>\n The researchers found that 11 percent of MDD episodes fulfilled criteria for TRD, with a median time from the start of MDD episode to TRD of 552 days. TRD episodes had more inpatient bed-days (mean, 3.9 versus 1.3 days) and more lost workdays (mean, 132.3 versus 58.7 days) 12 months after the index date, compared with matched non-TRD episodes. Common comorbid conditions in TRD episodes included anxiety, stress, sleep disorder, and substance use disorder. TRD episodes were also associated with four times higher frequency of intentional self-harm. The all-cause mortality rate for patients with MDD and TRD episodes was 10.7 per 1,000 person-years at risk versus 8.7 per 1,000 person-years at risk among patients with MDD without TRD episodes (hazard ratio, 1.23). Severity of MDD at time of diagnosis was the most important prognostic factor for TRD.<\/p>\n “The median time between initiation of new antidepressant treatments was longer than recommended in current treatment guidelines, suggesting room for more structured and timely depression care,” the authors write.<\/p>\n Two authors disclosed financial ties to the pharmaceutical industry.<\/p>\n