Comorbidity and healthcare utilization in patients with treatment resistant depression: A large-scale retrospective cohort analysis using electronic health records

Adekkanattu, Prakash; Olfson, Mark; Susser, Leah; Patra, Braja Gopal; Vekaria, Veer; Coombes, Brandon J.; Lepow, Lauren; Fennessy, Brian; Charney, Alexander; Ryu, Euijung; Miller, Kurt D.; Pan, Lifang; Yangchen, Tenzin; Talati, Ardesheer; Wickramaratne, Priya; Weissman, Myrna M.; Mann, J. John; Biernacka, Joanna M.; Pathak, Jyotishman

doi:10.1016/j.jad.2022.12.044

Cited by 4 publications

(3 citation statements)

References 62 publications

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“…patients with non-TRD but also have a higher risk of suicide attempts and completed suicide rates [29][30][31]. These results point to the importance of screening the severity of depression as early as possible along with treatment resistance to reduce suicidal risk for depressive disorder patients in routine clinical practice.…”

Section: Plos Onementioning

confidence: 84%

“…This implies that their disease status was severe, and the possibility of treatment-resistant depression (TRD) emerged considering its definition as an inadequate response even after more than two qualifying antidepressants with or without antipsychotic use for an adequate treatment duration [ 28 ]. Several lines of research have shown that TRD patients not only suffer from higher medical costs than patients with non-TRD but also have a higher risk of suicide attempts and completed suicide rates [ 29 – 31 ]. These results point to the importance of screening the severity of depression as early as possible along with treatment resistance to reduce suicidal risk for depressive disorder patients in routine clinical practice.…”

Section: Discussionmentioning

confidence: 99%

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Risk factors of reattempt among suicide attempters in South Korea: A nationwide retrospective cohort study

Kim,

Yang,

Koh

et al. 2024

PLoS ONE

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This study aimed to identify underlying demographic and clinical characteristics among individuals who had previously attempted suicide, utilizing the comprehensive Health Insurance Review and Assessment Service (HIRA) database. Data of patients aged 18 and above who had attempted suicide between January 1 and December 31, 2014, recorded in HIRA, were extracted. The index date was identified when a suicide attempt was made within the year 2014. The medical history of the three years before the index date and seven years of follow-up data after the index date were analyzed. Kaplan-Meier estimate was used to infer reattempt of the suicide attempters, and Cox-proportional hazard analysis was used to investigate risk factors associated with suicide reattempts. A total of 17,026 suicide attempters were identified, of which 1,853 (10.9%) reattempted suicide; 4,925 (28.9%) patients had been diagnosed with depressive disorder. Of the reattempters, 391 (21.1%) demonstrated a history of suicide attempts in the three years before the index date, and the mean number of prior attempts was higher compared to that of the non-reattempters (1.7 vs.1.3, p-value < 0.01). Prior psychiatric medication, polypharmacy, and an increase in the number of psychotropics were associated with suicide reattempt in overall suicide attempters. (Hazard ratio (HR) = 3.20, 95% confidence interval [CI] = 2.56–4.00; HR = 2.42, 95% CI = 1.87–3.14; HR = 19.66, 95% CI = 15.22–25.39 respectively). The risk of reattempt decreased in individuals receiving antidepressant prescriptions compared to those unmedicated, showing a reduction of 78% when prescribed by non-psychiatrists and 89% when prescribed by psychiatrists. Similar risk factors for suicide reattempts were observed in the depressive disorder subgroup, but the median time to reattempt was shorter (556.5 days) for this group compared to that for the overall attempters (578 days). Various risk factors including demographics, clinical characteristics, and medications should be considered to prevent suicide reattempts among suicide attempters, and patients with depressive disorder should be monitored more closely.

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Section: Plos Onementioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Risk factors of reattempt among suicide attempters in South Korea: A nationwide retrospective cohort study

Kim,

Yang,

Koh

et al. 2024

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…We used the IQVIA, formerly Quintiles and IMS Health, Inc Medical Research Data (IMRD), database, which includes de-identified data from The Health Improvement Network (THIN), an electronic Cegedim healthcare database containing anonymised data for 16 million registered individuals from 739 practices across the UK. 13 The people included are broadly representative of the UK population in terms of age, gender, medical conditions and mortality. 14 Available routine individual-level data include: demographic details, diagnoses and symptoms, laboratory tests, area level social deprivation (using the Townsend score) and prescriptions issued by GPs.…”

Section: Methodsmentioning

confidence: 99%

Exploring the co-occurrence of depression, anxiety and insomnia symptoms, diagnoses and treatments in primary care: observational study using UK primary care data

Nimmons,

Bazo-Alvarez,

Avgerinou

et al. 2024

BJPsych open

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Background Depression, anxiety and insomnia often co-occur. However, there is a lack of research regarding how they cluster and how this is related to medication used to treat them. Aims To describe the frequencies and associations between depression, anxiety and insomnia, and treatment for these conditions in primary care. Method A retrospective cohort study using UK electronic primary care records. We included individuals aged between 18 and 99 years old with one or more records suggesting they had a diagnosis, symptom or drug treatment for anxiety, depression or insomnia between 2015 and 2017. We report the conditional probabilities of having different combinations of diagnoses, symptoms and treatments recorded. Results There were 1 325 960 records indicative of depression, anxiety or insomnia, for 739 834 individuals. Depression was the most common condition (n = 106 117 records), and SSRIs were the most commonly prescribed medication (n = 347 751 records). Overall, individuals with a record of anxiety were most likely to have co-occurring symptoms and diagnoses of other mental health conditions. For example, of the individuals with a record of generalised anxiety disorder (GAD), 24% also had a diagnosis of depression. In contrast, only 0.6% of those who had a diagnosis of depression had a diagnosis or symptom of GAD. Prescribing of more than one psychotropic medication within the same year was common. For example, of those who were prescribed an SNRI (serotonin-norepinephrine reuptake inhibitor), 40% were also prescribed an SSRI (selective serotonin reuptake inhibitor). Conclusions The conditional probabilities of co-occurring anxiety, depression and insomnia symptoms, diagnoses and treatments are high.

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Preclinical models of treatment-resistant depression: challenges and perspectives

Kolasa,

Faron-Górecka

2023

Pharmacol. Rep

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Treatment-resistant depression (TRD) is a subgroup of major depressive disorder in which the use of classical antidepressant treatments fails to achieve satisfactory treatment results. Although there are various definitions and grading models for TRD, common criteria for assessing TRD have still not been established. However, a common feature of any TRD model is the lack of response to at least two attempts at antidepressant pharmacotherapy. The causes of TRD are not known; nevertheless, it is estimated that even 60% of TRD patients are so-called pseudo-TRD patients, in which multiple biological factors, e.g., gender, age, and hormonal disturbances are concomitant with depression and involved in antidepressant drug resistance. Whereas the phenomenon of TRD is a complex disorder difficult to diagnose and successfully treat, the search for new treatment strategies is a significant challenge of modern pharmacology. It seems that despite the complexity of the TRD phenomenon, some useful animal models of TRD meet the construct, the face, and the predictive validity criteria. Based on the literature and our own experiences, we will discuss the utility of animals exposed to the stress paradigm (chronic mild stress, CMS), and the Wistar Kyoto rat strain representing an endogenous model of TRD. In this review, we will focus on reviewing research on existing and novel therapies for TRD, including ketamine, deep brain stimulation (DBS), and psychedelic drugs in the context of preclinical studies in representative animal models of TRD.

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Comorbidity and healthcare utilization in patients with treatment resistant depression: A large-scale retrospective cohort analysis using electronic health records

Cited by 4 publications

References 62 publications

Risk factors of reattempt among suicide attempters in South Korea: A nationwide retrospective cohort study

Risk factors of reattempt among suicide attempters in South Korea: A nationwide retrospective cohort study

Exploring the co-occurrence of depression, anxiety and insomnia symptoms, diagnoses and treatments in primary care: observational study using UK primary care data

Preclinical models of treatment-resistant depression: challenges and perspectives

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