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What next? A Bayesian hierarchical modeling re-examination of treatments for adolescents with selective serotonin reuptake inhibitor-resistant depression.
Suresh, Vikram; Mills, Jeffrey A; Croarkin, Paul E; Strawn, Jeffrey R.
Afiliação
  • Suresh V; Department of Economics, Carl H. Lindner College of Business, University of Cincinnati, Cincinnati, Ohio.
  • Mills JA; Department of Economics, Carl H. Lindner College of Business, University of Cincinnati, Cincinnati, Ohio.
  • Croarkin PE; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota.
  • Strawn JR; Department of Psychiatry and Behavioral Neuroscience, College of Medicine, University of Cincinnati, Cincinnati, Ohio.
Depress Anxiety ; 37(9): 926-934, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32579280
ABSTRACT

BACKGROUND:

Psychiatrists frequently struggle with how to sequence treatment for depressed adolescents who do not respond to an adequate trial of a selective serotonin reuptake inhibitor (SSRI). This study leveraged recent statistical and computational advances to create Bayesian hierarchal models (BHMs) of response in the treatment of SSRI-resistant depression in adolescents study to inform treatment planning.

METHODS:

BHMs of individual treatment trajectories were developed and estimated using Hamiltonian Monte Carlo no u-turn sampling. From the Monte Carlo pseudorandom sample, 95% credible intervals, means, posterior tail probabilities, and so forth, were determined. Then, for the random effects model, posterior tail probabilities were used to create Bayesian two-tailed p values to evaluate the null hypotheses no difference in efficacy between SSRIs and venlafaxine. The robustness of the results was examined using the fixed effects model of treatment comparisons.

RESULTS:

In patients not receiving cognitive behavioral therapy (CBT; n = 168), SSRIs produced greater and faster improvement in depressive symptoms compared to venlafaxine (p = .015). No differences in response or trajectory of response for symptoms of anxiety were detected between SSRIs and venlafaxine (p = .168). For patients receiving CBT (n = 162), SSRIs and venlafaxine produced similar improvements in symptoms of anxiety and depression.

CONCLUSIONS:

Findings from this novel computational approach suggest that a second trial of an SSRI is warranted for depressed adolescents who fail to respond to initial SSRI treatment.
Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Tipo de estudo: Estudo prognóstico Idioma: Inglês Revista: Depress Anxiety Assunto da revista: Psiquiatria Ano de publicação: 2020 Tipo de documento: Artigo

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Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Tipo de estudo: Estudo prognóstico Idioma: Inglês Revista: Depress Anxiety Assunto da revista: Psiquiatria Ano de publicação: 2020 Tipo de documento: Artigo