Epidemiology of pharmaceutically treated depression and treatment resistant depression in Taiwan

Fife, Daniel; Feng, Yu; Wang, Michael Yao-Hsien; Chang, Ching‐Jui; Liu, Chia-Yih; Juang, Horng‐Heng; Furnback, Wesley; Singh, Jaskaran; Wang, Bruce

doi:10.1016/j.psychres.2017.03.006

Cited by 45 publications

(61 citation statements)

References 40 publications

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“…Results of the sequenced treatment alternatives to relieve depression (STAR*D) trial showed a 50% cumulative remission rate in outpatients with MDD after two different antidepressant (AD) regimens of adequate dose and duration, and the likelihood of remission substantially decreased after two regimens [18,19]. The failure of two adequate AD regimens is a common criterion for defining TRD [20,21].…”

Section: Introductionmentioning

confidence: 99%

All-cause mortality in patients with treatment-resistant depression: a cohort study in the US population

Fife

Wang

et al. 2019

Ann Gen Psychiatry

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Background Treatment-resistant depression (TRD) may represent a substantial proportion of major depressive disorder (MDD); however, the risk of mortality in TRD is still incompletely assessed. Methods Data were obtained from Optum Clinformatics™ Extended, a US claims database. Date of the first antidepressant (AD) dispensing was designated as the index date for study entry and 6 months prior to that was considered the baseline period. Patients with MDD aged ≥ 18 years, index date between January 1, 2008 and September 30, 2015, no AD claims during baseline, and continuous enrollment in the database during baseline were included. Patients who started a third AD regimen after two regimens of appropriate duration were included in the TRD cohort. All-cause mortality was compared between patients with TRD and non-TRD MDD using a proportional hazards model and Kaplan–Meier estimate with TRD status being treated as a time-varying covariate. The model was adjusted for study year, age, gender, depression diagnosis, substance use disorder, psychiatric comorbidities, and Charlson comorbidity index. Results Out of 355,942 patients with MDD, 34,176 (9.6%) met the criterion for TRD. TRD was associated with a significantly higher mortality compared with non-TRD MDD (adjusted HR: 1.29; 95% CI 1.22–1.38; p < 0.0001). Survival time was significantly shorter in the TRD cohort compared with the non-TRD MDD cohort (p < 0.0001). Conclusions Patients with TRD had a higher all-cause mortality compared with non-TRD MDD patients.

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Section: Introductionmentioning

confidence: 99%

All-cause mortality in patients with treatment-resistant depression: a cohort study in the US population

Fife

Wang

et al. 2019

Ann Gen Psychiatry

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“…For example, the administrative data must contain information of deaths and their causes, records of suicide attempts, as well as data on MDD diagnosis and treatment trials during a sufficient follow-up time in order to identify patients with TRD. As a proxy for identifying treatment resistance, the method of using prescription data in modeling TRD has been increasingly used in register studies Risk Factors for Suicide and Suicide Attempts (Corey-Lisle, Birnbaum, Greenberg, Marynchenko, & Claxton, 2002;Fife et al, 2017;Gronemann, Jorgensen, Nordentoft, Andersen, & Osler, 2018;Reutfors et al, 2018;Thomas et al, 2013). In these studies, the rate of TRD among antidepressant initiators has consistently been lower compared to in clinical studies, ranging from 12 to 20%.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Suicide and Suicide Attempts Among Patients With Treatment-Resistant Depression: Nested Case-Control Study

Reutfors

Andersson

Tanskanen

et al. 2019

Archives of Suicide Research

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The risk of suicide is elevated among patients with treatment-resistant depression (TRD). Risk factors for suicide and suicide attempts among cases and controls with TRD were investigated using data from nationwide Swedish registers. Among 119,407 antidepressant initiators with a diagnosis of depression, 15,631 patients who started a third sequential treatment trial during the same depressive episode were classified with TRD. A nested casecontrol study compared cases with suicide and suicide attempts with up to three closely matched controls. Sociodemographic and clinical risk factors were assessed using conditional logistic regression analyses. In all, 178 patients died by suicide and 1,242 experienced a suicide attempt during follow-up. History of suicide attempts, especially if <1 year after the attempt, was a significant independent risk factor for suicide (adjusted odds ratio [aOR], 8.9; 95% confidence interval [CI], 5.1-15.7) as were 10 to 12 years of education compared to lower education (aOR, 1.69; 95% CI, 1.02-2.81). For attempted suicide, the strongest independent risk factors were history of suicide attempts (<1 year aOR, 5.1; 95% CI, 4.0-6.5), substance abuse (aOR, 2.6; 95% CI, 2.2-3.1), personality disorders (aOR, 1.9; 95% CI, 1.5-2.3), and somatic comorbidity (aOR, 2.0; 95% CI, 1.04-3.9). Suicide attempts, especially if recent, are strong risk factors for completed suicide among patients with TRD. Established risk factors for suicide attempts were confirmed for patients with TRD.

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“…We therefore repeated the analysis with a 6 months cap on time from onset of PTD to TRD. In this supplemental, post-hoc, analysis, 68 PTD subjects, 2.47%, (95% CI: 1.94, 3.10) developed TRD; i.e., 0.10 (95% CI: 0.08, 0.12) incident cases/1000 population [4].…”

Section: Introductionsmentioning

confidence: 86%

“…Average hospitalization costs were higher for TRD than non-TRD episodes [6] Treatment of TRD have been one of clinical problems. Adjunctive antipsychotics was a most sued ways [4], especially adjunctive aripiprazole showed benefits in improving the response rate, remission rate, and the quality of life in patients with TRD [7]. The success of switching to a different antidepressant following a first-line agent is supported by evidence, but there is limited evidence for effective combination strategies.…”

Section: Introductionsmentioning

confidence: 99%

The Role of the Magnesium Valproate in Therapy for Patients with Treatment-Resistant Depression (TRD): Meat-Analysis Results of Chinese Data

Fengpei¹

2018

IJPC

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Background: Major depressive disorder is a prevalent and disabling illnessv, approximately 70% of patients do not remit after first-line antidepressant treatment, and about 20% develop to treatment-resistant depression(TRD). Treatment of TRD have been one of clinical problems. Adjunctive valprovate was a most sued ways for treatment of TRD. The magnesium valproate was common drug for both episode and bipolar disorder in China and also was used for TRD. To systematically evaluate the difference in efficacy of magnesium valproate and antidepressants for therapy of treatment-resistant depression(TRD) in China. Methods: Searches were applied to the following electronic databases in china: Chinese Biomedical Database (CBM), China National Knowledge Infrastructure (CNKI), WANFANG and Chinese Social Sciences Citation Index (VIP) databases. A total of 13 RCTs were included. A meta-analysis was performed of all the literatures germane to estimate the treatment-resistant depression patients treated with magnesium valproate combination with antidepressants and only antidepressants randomized controlled trials (RCTs) from 2010 to 2015. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated and the meta-analysis was conducted with Revman4.2 software. Results: A total of 13 RCTs were included for meta-analysis. The results of meta-analysis demonstrated by effective rate and depressive symptoms change between two groups of combination treatment with magnesium valproate and only antidepressant. The effective rate was higher in magnesium valproate combination with antidepressants group than that in antidepressants group(81/306, 35/298, Z=4.60, P=0.00001). The depressive scale was lower found in magnesium valproate combination with antidepressants group than that in antidepressants group after treatment (Z=16.20, P <0.00001). These results indicated that magnesium valproate combination with antidepressants maybe one better therapeutic way for TRD. Conclusion: The results indicate that magnesium valproate combination with antidepressants was better than antidepressants group in effective rate and improving depressive symptoms during treatment of patients with TRD. So these results may recommend to the patients with TRD though without the differences between groups.

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Epidemiology of pharmaceutically treated depression and treatment resistant depression in Taiwan

Cited by 45 publications

References 40 publications

All-cause mortality in patients with treatment-resistant depression: a cohort study in the US population

All-cause mortality in patients with treatment-resistant depression: a cohort study in the US population

Risk Factors for Suicide and Suicide Attempts Among Patients With Treatment-Resistant Depression: Nested Case-Control Study

The Role of the Magnesium Valproate in Therapy for Patients with Treatment-Resistant Depression (TRD): Meat-Analysis Results of Chinese Data

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