Multiple secondary data analyses of TORDIA have identified important predictors of treatment response and relapse .
To up date a comparative effectiveness review ( 1980–2011 ) of treatments for adolescents whose depressive episode or disorder ( MDE/MDD ) did not respond to one or more trials of SSRI antidepressants .
Impact of physical and sexual abuse on treatment response in the Treatment of Resistant Depression in Adolescent Study (TORDIA).
OBJECTIVE We previously reported that a history of abuse was associated with a poorer response to combination treatment  in the Treatment of Resistant Depression in Adolescents study ( TORDIA ) . We now report on the nature and correlates of abuse that might explain these findings . METHOD Youth who did not benefit from an adequate selective serotonin re-uptake inhibitor ( SSRI ) trial ( N = 334 ) were r and omized to one of the following : an alternative SSRI ; an alternative SSRI plus cognitive behavior therapy ( CBT ) ; venlafaxine ; or venlafaxine plus CBT . Analyses examined the effect of history of abuse on response to the pharmacotherapy and combination therapy . RESULTS Those without a history of physical abuse ( PA ) or sexual abuse ( SA ) had a higher 12-week response rate to  combination therapy  compared with medication mono-therapy ( 62.8 % versus 37.6 % ; odds ratio [ OR ] = 2.8 , 95 % confidence interval [ CI ] = 1.6 - 4.7 , p < .001 ) . Those with a history of SA had similar response rates to combination versus medication monotherapy ( 48.3 % versus 42.3 % ; OR = 1.3 , 95 % CI = 0.4 - 3.7 ; p = .66 ) , whereas those with history of PA had a much lower rate of response to  combination therapy  ( 18.4 % versus 52.4 % , OR = 0.1 ; 95 % CI = 0.02 - 0.43 ) . Even after adjusting for other clinical predictors , a history of PA moderated treatment outcome . CONCLUSION These results should be considered within the limitations of a post hoc analysis , lack of detailed assessment of abuse and other forms of trauma , and neuropsychological status . Depressed patients with history of abuse , especially PA may require specialized clinical approaches . Further work is needed to underst and by what mechanisms a history of abuse affects treatment response
Multiple secondary data analyses of TORDIA have identified important predictors of treatment response and relapse .
To up date a comparative effectiveness review ( 1980–2011 ) of treatments for adolescents whose depressive episode or disorder ( MDE/MDD ) did not respond to one or more trials of SSRI antidepressants .