No CrossRef data available.
Article contents
Comparison of Staging Methods for Treatment-Resistant Depression: Chart Review
Published online by Cambridge University Press: 27 August 2024
Abstract
Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Introduction
Treatment-resistant depression (TRD) lacks a universally consistent definition due to varied interpretations despite attempts to define it based on inadequate response or remission despite sufficient antidepressant treatment. There’s a crucial demand for a uniform definition and staging to streamline its effective management amid diverse treatment options and the complex nature of resistance. Five methods have emerged to define and classify treatment resistance reliably.
Objectives
The aim of this study is to compare the five staging methods (Thase&Rush SM (T&R), European Staging Method (ESM), Maudsley Staging Method (MSM), Massachusetts General Hospital Staging Method (MHG-s), Conway Staging Method(Conway)) in assessing treatment resistance within a single sample.
Methods
Retrospective analysis involved medical records of inpatient psychiatry clinic admissions at Hacettepe University between October 2012 and October 2014. Patients with a primary diagnosis of bipolar affective disorder, schizophrenia, other chronic psychotic disorders, dementia or cognitive disorders, alcohol and substance use disorders, and those with missing data were excluded.
Results
Initial screening yielded a total of 115 patients. 64 patients were included in the study, 13 patients were excluded due to missing data, and 38 patients were excluded due to comorbidity.
| Characteristic | Total (N=64) | Last Episode Characteristics | Total (N=64) |
|---|---|---|---|
| Female - N(%) | 44 (69) | Episode duration – month (mean ± SD) | 13.75 ± 16.09 |
| Age – yr (mean ± SD) | 48.39 ± 18.81 | Psychotic symptoms – N(%) | 20 (31) |
| Married – N(%) | 41 (64) | Anxiety symptoms – N(%) | 24 (38) |
| Secondary school and over – N(%) | 38 (59) | Suicidal attempt – N(%) | 19 (30) |
| Employed – N(%) | 16 (25) |
| TRD definition and staging method (N=55) | T&R | ESM | MSM | MGH-S | Conway |
|---|---|---|---|---|---|
| Not resistant by this method | 26 (47.3) | 45 (81.8) | 0 (0) | 27 (49.1) | 43 (78.2) |
| Identified by this method | 29 (52.7) | 10 (18.2) | 55 (100) | 28 (50.9) | 12 (21.8) |
| Exclusively identified by this method | 0 (0) | 0 (0) | 21 (38.2) | 0 (0) | 0 (0) |
| By this and one other method | 27 (49.1) | 0 (0) | 11 (20) | 5 (9.1) | 0 (0) |
| By all methods | 10 (18.2) | 10 (18.2) | 10 (18.2) | 10 (18.2) | 10 (18.2) |
| Identified as TRD | |||||
| Age of onset (mean ± SD) | 40.28 ± 17.42 | 35.6 ± 18.27 | 40.44 ±18.38 | 40.07 ± 17.9 | 38.17 ± 17.71 |
| ATHF score (mean ± SD) | 7.55 ± 5.46 | 12.1 ± 6.51 | 4.93 ± 4.98 | 7.43 ± 5.69 | 11.08 ± 6.47 |
| Last episode duration (month) (mean ± SD) | 17.11 ± 17.25 | 22.10 ± 20.96 | 14.22 ± 17.08 | 16.33 ± 17.66 | 20.83 ± 19.25 |
Conclusions
There is no universally agreed-upon definition for treatment resistance. In this sample, different definition and staging methods were employed to examine the similarities and differences in the clinical and treatment related characteristics of groups with TRD identified with each. The reasons and possible implication of concurrence and discordance between the methods will be discussed.
Disclosure of Interest
None Declared
- Type
- Abstract
- Information
- European Psychiatry , Volume 67 , Special Issue S1: Abstracts of the 32nd European Congress of Psychiatry , April 2024 , pp. S255 - S256
- Creative Commons
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.- Copyright
- © The Author(s), 2024. Published by Cambridge University Press on behalf of European Psychiatric Association
You have
Access
Open access
Comments
No Comments have been published for this article.