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Treatment-Resistant Depression in Adolescents: Clinical Features and Measurement of Treatment Resistance.
Strawn, Jeffrey R; Aaronson, Scott T; Elmaadawi, Ahmed Z; Schrodt, G Randolph; Holbert, Richard C; Verdoliva, Sarah; Heart, Karen; Demitrack, Mark A; Croarkin, Paul E.
Afiliação
  • Strawn JR; Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
  • Aaronson ST; Divisions of Child and Adolescent Psychiatry and Clinical Pharmacology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
  • Elmaadawi AZ; Sheppard Pratt Health System, Baltimore, Maryland, USA.
  • Schrodt GR; Indiana University School of Medicine, Beacon Health System, South Bend, Indiana, USA.
  • Holbert RC; Integrative Psychiatry, Louisville, Kentucky, USA.
  • Verdoliva S; Shands Psychiatric Hospital, University of Florida Department of Psychiatry, Gainsville, Florida, USA.
  • Heart K; NAMSA, Minneapolis, Minnesota, USA.
  • Demitrack MA; Neuronetics, Inc., Malvern, Pennsylvania, USA.
  • Croarkin PE; Trevena, Inc., Chesterbrook, Pennsylvania, USA.
J Child Adolesc Psychopharmacol ; 30(4): 261-266, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32315537
ABSTRACT

Objective:

To describe the clinical characteristics of adolescents with antidepressant treatment-resistant major depressive disorder (MDD) and to examine the utility of the Antidepressant Treatment Record (ATR) in categorizing treatment resistance in this population.

Methods:

Adolescents with treatment-resistant MDD enrolled in an interventional study underwent a baseline evaluation with the ATR, Children's Depression Rating Scale-Revised (CDRS-R), and Clinical Global Impressions-Severity (CGI-S) scales. Demographic and clinical characteristics were examined with regard to ATR-defined level of resistance (level 1 to ≥3) using analysis of variance and χ2 tests.

Results:

In adolescents with treatment-resistant MDD (N = 97), aged 12-21 years, most were female (65%), white (89%), and had recurrent illness (78%). Patients were severely ill (median CGI-S score of 5), had a mean CDRS-R score of 63 ± 10, and 17.5% had been hospitalized for depression-related symptoms. Fifty-two patients were classified as ATR 1, whereas 32 were classified as ATR level 2 and 13 patients as ≥3, respectively. For increasing ATR-defined levels, illness duration increased from 12.0 (range 1.5-31.9) to 14.8 (range 1.8-31.7) to 19.5 (range 2.5-36.2) months and the likelihood of treatment with serotonin norepinephrine reuptake inhibitors (SNRIs) and dopamine norepinephrine reuptake inhibitors (DNRIs) similarly increased (p = 0.006 for both SNRIs and DNRIs) as did the likelihood of treatment with mixed dopamine serotonin receptor antagonists (χ2 = 17, p < 0.001).

Conclusions:

This study underscores the morbidity and chronicity of treatment-resistant MDD in adolescents. The present characterization of related clinical features describes the use of nonselective serotonin reuptake inhibitors in adolescents with treatment-resistant depression and raises the possibility that those with the greatest medication treatment resistance are less likely to have had recurrent episodes. The study also demonstrates the utility of the ATR in categorizing treatment resistance in adolescents with MDD.
Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Idioma: Inglês Revista: J Child Adolesc Psychopharmacol Assunto da revista: Pediatria / Psicofarmacologia Ano de publicação: 2020 Tipo de documento: Artigo País de afiliação: Estados Unidos

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Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Idioma: Inglês Revista: J Child Adolesc Psychopharmacol Assunto da revista: Pediatria / Psicofarmacologia Ano de publicação: 2020 Tipo de documento: Artigo País de afiliação: Estados Unidos
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