Influence of Panic-Agoraphobic Spectrum Symptoms on Treatment Response in Patients With Recurrent Major Depression

Frank, Ellen; Mk, Shear; Rucci, Paola; Jm, Cyranowski; Endicott, Jean; Fagiolini, Andrea; Vj, Grochocinski; Houck, Patricia R.; Dj, Kupfer; Jd, Maser; Cassano, Gb

doi:10.1176/appi.ajp.157.7.1101

Cited by 106 publications

(87 citation statements)

References 21 publications

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“…First, a higher proportion of nonresponders than responders had a comorbid anxiety disorder. This is not unexpected given findings of poorer treatment outcome in depressed patients having a comorbid anxiety disorder (Fava et al, 1997;Frank et al, 2000). The comorbidity difference is not likely to be a critical factor because the difference in asymmetry between responders and nonresponders remained the same when patients having comorbidity were excluded from analyses.…”

Section: Discussionmentioning

confidence: 74%

Dichotic Listening Tests of Functional Brain Asymmetry Predict Response to Fluoxetine in Depressed Women and Men

Bruder

Stewart

McGrath

et al. 2004

Neuropsychopharmacol

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Patients having a depressive disorder vary widely in their therapeutic responsiveness to a selective serotonin reuptake inhibitor (SSRI), but there are no clinical predictors of treatment outcome. Studies using dichotic listening, electrophysiologic and neuroimaging measures suggest that pretreatment differences among depressed patients in functional brain asymmetry are related to responsiveness to antidepressants. Two new studies replicate differences in dichotic listening asymmetry between fluoxetine responders and nonresponders, and demonstrate the importance of gender in this context. Right-handed outpatients who met DSM-IV criteria for major depression, dysthymia, or depression not otherwise specified were tested on dichotic fused-words and complex tones tests before completing 12 weeks of fluoxetine treatment. Perceptual asymmetry (PA) scores were compared for 75 patients (38 women) who responded to treatment and 39 patients (14 women) who were nonresponders. Normative data were also obtained for 101 healthy adults (61 women). Patients who responded to fluoxetine differed from nonresponders and healthy adults in favoring left-over righthemisphere processing of dichotic stimuli, and this difference was dependent on gender and test. Heightened left-hemisphere advantage for dichotic words in responders was present among women but not men, whereas reduced right-hemisphere advantage for dichotic tones in responders was present among men but not women. Pretreatment PA was also predictive of change in depression severity following treatment. Responder vs nonresponder differences for verbal dichotic listening in women and nonverbal dichotic listening in men are discussed in terms of differences in cognitive function, hemispheric organization, and neurotransmitter function.

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Section: Discussionmentioning

confidence: 74%

Dichotic Listening Tests of Functional Brain Asymmetry Predict Response to Fluoxetine in Depressed Women and Men

Bruder

Stewart

McGrath

et al. 2004

Neuropsychopharmacol

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show abstract

“…In our study sample, rates of comorbid PTSD (66% in ours versus 28% in the perinatal study) and borderline personality disorder (37% in ours; not reported in the perinatal study) accounted for significant variability in depression outcomes. In our sample, 86% of participants had at least one comorbid anxiety disorder (versus 56% in the perinatal sample), which could suppress treatment response (34). Furthermore, depression chronicity in our sample may explain the less robust treatment gains, as was found in a recent meta-analysis of treatments for chronic depression (39).…”

Section: Discussionmentioning

confidence: 97%

“…Possible contributors to incomplete treatment response include predominance of chronic depression (73% of the sample), high rate of comorbid disorders, interpersonal sequelae of extensive trauma exposure, and socioeconomic disadvantage. Comorbid disorders, including PTSD and borderline personality disorder, are associated with worse treatment outcomes (34–37). The interpersonal resources of many women were extremely limited and marked by conflictual family relationships, responsibilities of single parenthood, and social isolation.…”

Section: Discussionmentioning

confidence: 99%

A Randomized Effectiveness Trial of Interpersonal Psychotherapy for Depressed Women With Sexual Abuse Histories

Talbot¹,

Chaudron²,

Ward³

et al. 2011

Psychiatric Services

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Objectives Many depressed women seen in community mental health centers (CMHCs) have histories of childhood sexual abuse and are economically disadvantaged. Randomized trials are needed to test the effectiveness of evidence-based interventions in this population and setting. This study compared interpersonal psychotherapy with usual care psychotherapy among women in a CMHC. Methods Among 1,100 women seeking treatment in a CMHC, 230 (21%) had major depression and histories of childhood sexual abuse. Seventy women with major depression and sexual abuse before age 18 were randomly assigned to interpersonal psychotherapy (N=37) or usual care psychotherapy (N=33). Staff clinicians provided all treatments. Participants were assessed at study entry and at ten, 24, and 36 weeks after random assignment. Generalized estimating equations were used to examine change over time. Results Compared with women assigned to usual care, women who received interpersonal psychotherapy had greater reductions in depressive symptoms (Hamilton Rating Scale, p=.05, d=.34; Beck Depression Inventory–II, p=.01, d=.29), posttraumatic stress disorder symptoms (p=.04, d=.76), and shame (p=.002, d=.38). Interpersonal psychotherapy and usual care yielded comparable improvements in social and mental health–related functioning. Conclusions Interpersonal psychotherapy compared favorably to usual care psychotherapy in a CMHC in improving psychiatric symptoms and reducing shame among sexually abused women. However, there is a critical need for continued research to develop more effective treatments for the social and psychiatric sequelae of interpersonal trauma and socioeconomic disadvantage.

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“…Interpersonal therapy was not successful in preventing recurrence of depression in MTLD-2 . Anxiety and panic symptoms in particular have been associated with poorer response to interpersonal therapy in midlife depressed patients (Frank et al, 2000), with lower levels of stress sensitivity representing an independent predictor of poor response. Anxious patients may feel particularly overwhelmed by interpersonal stress and may avoid problems instead of actively tackling them.…”

Section: Discussionmentioning

confidence: 99%

Residual symptoms and recurrence during maintenance treatment of late-life depression

Dombrovski

Mulsant

Houck

et al. 2007

Journal of Affective Disorders

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138

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Influence of Panic-Agoraphobic Spectrum Symptoms on Treatment Response in Patients With Recurrent Major Depression

Cited by 106 publications

References 21 publications

Dichotic Listening Tests of Functional Brain Asymmetry Predict Response to Fluoxetine in Depressed Women and Men

Dichotic Listening Tests of Functional Brain Asymmetry Predict Response to Fluoxetine in Depressed Women and Men

A Randomized Effectiveness Trial of Interpersonal Psychotherapy for Depressed Women With Sexual Abuse Histories

Residual symptoms and recurrence during maintenance treatment of late-life depression

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